Tuesday, August 6, 2013

A {Really Verbose} Birth Story

Be warned - this post will take almost as long to read as the actual labor and delivery. Just sayin'

38 Weeks
This birth story really starts with Cadence's birth. I know - I'm already verbose, do I really have to do a back story for the birth story too?! Well… Yeah.

There were four things different about this birth story than with any of my others. And they were all because of a difference in doctors. The four new things were:

-asking preference without judgment
-no pressure
And I loved these four new things! 

With Cadence my doctor really pressured me to induce for his convenience. And when that didn't work, he lied to me to get me to induce. Then, when that didn't work, he threatened me with the imminent death of my (healthy, might I mention) baby. I finally caved in and induced. Thank the Lord He blessed and Cadence's birth went shockingly smoothly, although recovery was quite miserable.

Because of this experience, I was left completely untrusting of doctors. I switched to a doctor who worked closer, and while I was wary, I felt better prepared to stand up for my choices and rights. She might not respect me, but she wasn't going to bulldoze me! As it turned out, she didn't try to bulldoze me. I could tell she would rather just induce and get it over with, but I didn't feel overly pressured. At birth, she came in, did her thing, and left. James' birth went very smoothly, but she never bothered to ask my preference on anything, or communicate with me about what was going on.

This time, I was grateful to know what I was getting into. I might not feel any bond with my doctor, but I knew she would let me do my thing, and I felt safe.

Then she moved. And I had to switch doctors. Again. This time mid-pregnancy. I was scared and nervous. I wanted to stick with a Moore doctor, because we loved the hospital there, and the only one left was male. My last experience with a male doctor was not pleasant, but I heard great things about this one, so I decided to at least give a try.

Then the hospital was destroyed in a tornado a few days before my first appointment with the new doctor. We met in a temporary office, and I was a bit too frazzled to ask any questions. My first impression was that he seemed nice enough and we would get along just fine, but I wasn't reassured at all about his medical care. The next appointment I asked him about inductions, and he told me he would never pressure me to do something I didn't want to do, especially if there was no medical reason. He brought up going overdue, and a few other reasons me might suggest it, then reassured me that it would still be my choice. I felt a little better, but was still a little wary.

I stayed wary my entire pregnancy.

Then I tested positive for Group B Strep. This is a virus that all women have at some points in the their life. It randomly comes and goes, and you don't even know you have it because it's completely harmless to adults in this form. However, if a woman gives birth while they have it, the baby can contract it, and it can be fatal.

Now, for most women this is not an issue. They go into labor, they go to the hospital, they get hooked up to antibiotics, and four hours later it is completely safe for the baby to be born. The problem for me is four hours part.

My first labor, even though it was induced, was only 4.5 hours. My second labor, from first contraction to holding the baby, was 3.5 hours.

How was I supposed to take long enough to be sure I was in labor, drive to the hospital, get checked in, and have four hours of IV's, if my labor was less than four hours long?!

And so, the doctor brought up induction.

And I was impressed.

As soon as he said the results were positive, I thought, "Oh, here it comes. I'm not going to be given a choice, really, he's just going to push and push the issue until I cave in." But it wasn't like that at all.
He laid everything out for me. He said if we induced we could hopefully beat the baby but still get past thirty-nine weeks. We would start the IV, let it finish, and then give me a little Pitocin to start contractions. From there, since I had had preciptious labors in the past, it would probably be smooth sailing. He said there wasn't much scientific research, but with a third time mom who was already dilated and ready to go, who had had super quick, easy labors in the past, plus a successful induction once already, the chances of something going wrong and winding up with a c-section were not much higher than going into labor naturally. I knew this to be true, and told him I would very seriously consider it.

Then, he shocked me by telling me I had another choice. He said, "Now, I know you want the baby with you always after birth, but here's how it could go if we don't induce. I want you to have what you want - you just have to decide which path you want to take and let me know. My job is to give you all the information I have, and help you make the choice that will make things work best for you." He explained if my labor was too short, the worst case scenerio would be the baby having to have her own IV of antibiotics. Because of the hospital we would be delivering at (remember the tornado? New hospital to go along with the new doctor!) they would take the baby to the nursery to do this, and she would be gone quite a while. He said this would automatically happen - first they would do a quick blood draw and test the blood to see if she was positive for the strep B. No Strep B, no IV. It would just depend.
I was impressed that he was still willing to let me choose. I was torn. I really, really, didn't want to risk having my baby away from me. I know it seems like a small thing, and I know it would have been fine, but it was just important to me. I let them go ahead and schedule an induction for that Thursday  and my next doctors appointment on Friday, to leave my options open.

Monday morning I woke Tony up. "I just can't do the induction. I just feel God is saying, OK, you said you trusted me with this baby, and now you're taking things into your own hands. Let go of doing something, and just trust me to take care of things." He said he had been feeling the same way, so I called and cancelled the induction. I have never felt so relieved and at peace.

I knew God was in control, and He would take care of things. And if the baby had to be in the nursery, He would take care of that too.

The doctors reaction was funny. He said, "Alright, I'll see you when you're in labor. Now, here is your script - you walk in and say, loudly, "My name is Sally Chancellor. I have Group B Strep and precipitous labors, and Dr ____ said to hurry with the IV." Pretend you're at an AA meeting and make sure they know who you are!"

As it turns out, it wouldn't have mattered if I had left the induction scheduled.

I suspect my labor officially began around 3:00 Tuesday afternoon. I started having contractions about every 15-20 minutes, and they lasted throughout the evening and night. They felt "real", but were not particularly intense. They were also rather sporadic - there was never a gap longer than 30 minutes while I was awake, but some would be ten, then thirty, then a fifteen, then twenty, then another thirty… They never really leveled out and got serious. They also didn't become more intense, so I wasn't feeling overly certain it was the real thing. I also knew even if it was it could be a while at that rate.

For the most part I just tried to ignore them and not get worked up or excited. We warned everyone involved in the babysitting / rush to the hospital plan and tried to rest. Tuesday night was not overly restful. I didn’t wake with every contraction, thankfully, but I did wake up about every hour. About four I took a nice hot shower and washed my hair. By now I was sure I was in labor and didn't know when I would have another chance to do this. I had always heard of people saying, "Rest between contractions, take a shower, try to relax…" and could not fathom this concept. How were you supposed to have a shower and rest between contractions when your labor started with contractions 5 minutes apart and only lasted 3.5 hours? Now I understood.

I was encouraged and excited that I was having a 'long' labor this time. We had been hoping to have at least four hours in the hospital hooked to an IV. That was the only way to be completely sure baby would not need to be away and have IV's.

Then things changed and went back to 'normal'.

Tony generally leaves for work about 7:00. Wednesday was supposed to be his first official day back at work, so he got ready as usual. As he was leaving I said, "I'm not completely sure you should go to work. But… I'm also not sure you should stay home…" We decided to go ahead and try it - after all, we had no way of knowing this wouldn't last all day. And that was that.

At 7:10 I had another contraction, and suddenly they were only 8 minutes apart and narrowing quickly, just like with James. I called Kari to come for the kids, called Tony to head home - he wasn't even all the way to work yet - and called Mommy so she could head this way from Tulsa. Tony got here about two minutes before Kari, we loaded the kids up, loaded ourselves up, and headed to the hospital.

This was my first experience with back labor, and it is not my favorite! There isn't really a good position to get in when your back hurts.

By the time we arrived I was 'slow breathing' through the contractions - which meant I had to stop talking, but they weren't really difficult to deal with. I told the nurse my scripted line, and she got us back to triage, but didn't seem in any particular hurry. When the nurse checked me she said, "Well, you're at a six… well, I'll say seven." Then she wrote eight on my chart. When I heard seven I knew we were doomed - from seven to eight with our second baby was only an hour-and-a-half.

Apparently another nurse heard I was there and remembered my doctor warning them. Things moved a little more quickly then - we had about four nurses working at the same time, one checking me in, one drawing blood, one asking questions, one setting up the IV, one gathering supplies, etc. I was thankful to get the IV in, just in case we did have another four hours.

Later we found out that in all the hubbub, they had forgotten to actually call my doctor and tell him I was in labor. He was there checking on another patient, and noticed my chart.

Thankfully I had braced myself for the possibility of not getting all the antibiotics myself, so I wasn't too concerned. The nurses had reassured me they would only do a little extra blood work - it didn't mean baby would automatically be whisked away to the nursery for an IV and not returned for several hours. With that in mind, I was able to push aside any worries and focus on contractions.

Things got steadily more intense. As soon as all the extra nurses left and just the one who would be with me through the last of my labor remained, I transferred to a birthing ball. Really, it's just an exercise ball, but it has been my lifeline through all three labors. I very seriously doubt I could have an unmedicated birth without one - there is just no way I can personally get comfortable in a bed or chair. It's just awkward. I'm the sort who settles in and doesn't move through the last stages of labor, so I hung out on the ball, draping myself over the bed to breathe during contractions.

It was about this point Tony said, "I know why they tell you to breathe like that! You're saying, "Eve, Eve, oooooo!!!!!! Eve, Eve, ooooooo!!!!!! Because you're mad at her!" This of course made me laugh, completely ruining my concentration. Gotta love someone who can make you laugh in the middle of transition *eye roll*.

My back was still hurting, so Tony came and pressed on my lower back between contractions. It almost felt like he was pushing the pain from back to front, and it must have worked, because after that I didn't have any more back pain until almost time to push! The contractions never did get quite so intense or close together this time - it was by far my easiest labor, in spite of the back pain at first.

We had an awesome nurse through labor. Baby was a wiggle worm and didn't like to have her heartbeat tracked, but instead of making me move or messing up my concentration - or worse, making me lie down- the nurse just ever so quietly held the monitor to my stomach, following baby around as she wriggled through my contractions.

About 10:30 I started to feel like I needed to push, so the nurse called the doctor and helped me get settled in bed. Unfortunately, the doctor had just stepped into an emergency C-section, so we settled in to see if we could wait. The contractions were a little further apart now, so we started talking with the nurses to keep occupied. Thankfully it didn't take more than fifteen minutes and he came in, stripping off surgery plastic as he came. He greeted us with, "Well, there is entirely too much laughing and joking going on in here!"

Of course, since the doctor was there the next contraction took it's time coming. When it finally came I pushed the baby all the way to the ready position. Since it was a long ways at once we didn't push between contractions, so they could make sure she had handled it ok. After that it was push, push, push. I was very impressed with the doctor. He was the first to ever do any stretching, and when it was obvious I was going to tear instead of automatically cutting he actually asked me what I wanted him to do - "Sally, I need you to look at me and listen for a second. We have a big head and small opening, it's going to tear. Do you want me to cut it, or do you want to let it tear?" I decided to let it tear, and was so thankful he actually cared enough to ask. It was just one more time he had shown respect for my choices, asking without pressuring one way or another.

As we were pushing he told all the nurses about us wanting to spend as much time Mama and baby as possible, and not have the baby taken out of the room. This was also my first experience with a doctor remembering what we wanted and taking the effort to tell the nurses about it.

Just about the time I had decided I wasn't going to be able to push this baby out without losing my sanity, the doctor said, "Look down here, she's here!" and I felt an intense relief as her head came out. He immediately put her up on my chest, where she felt so incredibly tiny. "Oooo, she's a little one!" the nurses said. After the bulk of our surprisingly big second child, I fully expected them to tell us this little one weighed about four pounds. I held and snuggled her while the doctor fixed the tiny tears he had predicted, and once again he did something my other doctors didn't - he actually communicated. He told me exactly what he was doing, what had happened during crowning, and how I could expect it to heal. Tony cut the umbilical cord, something he never wanted to do before, and got to hold her. Then I let them take the baby to the bedside scales to be measured and wiped up a bit. Tony took pictures, and I rested for a moment. 

From the time my contractions became regular to delivery wound up being four hours and twenty minutes. Not quite precipitous, but not exactly prolonged.

We held baby and snuggled for a while, then let the grandparents come see her for a moment. Next was feeding her, which the nurses encouraged right away. She'd been rooting around, so we knew she was ready. She latched right on like a champ,  and was already swallowing even on that first feeding.
The only part of our hospital stay I wasn't enamored with was moving to a different room after delivery, but it turned out to not be a big deal. Once we were settled and baby had eaten again (yes, already), they took her to the nursery to do her blood work. We needed to make sure she didn't need antibiotics, so they had to take her then and also the next day.

All in all, it turned out to be a wonderful birth experience! Labor and delivery were as easy as can be expected, the nurses and doctors were communicative and respectful, and everyone took great care of us. The baby was born healthy and well, and didn't need antibiotics. I have recovered amazingly quickly.

I am so thankful for God's many blessings - the peace He gave us about not inducing, the easy delivery, the healthy baby, and a doctor I finally feel like I can trust.

1 comment:

Kristina said...

I'm so glad you had a good birth experience. For back pain, get on your hands and knees and rock back and forth. Also, as you found, direct pressure on the back helps, especially in that position. Love you!