Tuesday, May 21, 2013

My birthing experience

After being told at my first obstetrician's appointment that mine was a high-risk pregnancy due to 'advanced maternal age' and my previous history of kidney problems, and that I would have to be carefully and regularly monitored for pre-eclampsia and IUGR, I went on to have a wonderfully uneventful pregnancy. My blood pressure was a constant 100/60 throughout, and kidney function was 'too good' (according to my nephrologist). Peanut consistently measured above the 90th percentile in her growth ultrasounds and passed her biophysical profile tests with flying colors.

The expected due date was 21 May, but the baby had other ideas. She came two weeks early! Here's my birthing story.

May 7, Tuesday (38 weeks pregnant)
I woke up 9 am to find my panty unusually wet, but didn't give much thought to that. The rest of the day was normal (no more wetness).

May 8, Wednesday (38 weeks 1 day)
I woke up at 3 am and found that my panties were wet again. It didn't smell of pee. I couldn't get back to sleep, because I started thinking it might be amniotic fluid coming from a slow leak of my water bag. I sent a message to my doctor about this and then went to work tidying up the bathroom and medicine cabinet until daybreak.

10 am: Midwife calls about the message and we agree I should come in to get checked. I pack my hospital bag just in case. Already packed were a set of going home clothes for baby and I, comfy clothes for hubs, book, sanitary napkins. I hastily threw in a water bottle, my phone charger, wallet, some banana muffins, oranges, bananas, dried fruit snacks and toiletry bag.

12 pm: Meredith uses a speculum to see if any fluid has pooled near my cervix, and also swabs a sample of the fluid to look under the microscope. I'm 2 cm dilated?! The fluid sample is inconclusive. I'm scheduled for an ultrasound after lunch to check amniotic fluid levels. We discuss possible scenarios - if indeed the leak occurred May 7, it would be over 24 hours since that happened, and the risk of infection to baby much increased. They would suggest methods to get labor going, including the use of pitocin. I wasn't very happy about the pitocin part, and decided then that I would do whatever I could to  labor naturally. Thus begins Project Walk. I walk a mile to the Five Guys and have a burger and fries for lunch. I walk back to the hospital and am joined there by hubs, who (conveniently) works down the road. He goes back to work when it becomes apparent that my turn for the ultrasound would be a while yet, and I do laps around the small outdoor courtyard.

2.30 pm: The ultrasound looks normal, and amniotic fluid levels are high. While this is good, it doesn't mean there is no slow leak.

3.10 pm: Tracey finds a lot of fluid pooled near my cervix. I'm 4 cm dilated!!!!???? The microscopic examination is again inconclusive, but she decides to get me admitted because she feels in her gut that baby is coming. We have a discussion about possible scenarios. Pitocin figures quite prominently. I am to check in at Triage in about an hour.

4.20 pm: I brisk walk to Schenley Park carrying my backpack, determined to get labor started. I begin timing my barely there contractions: 2 minutes between contractions that last about 30 seconds. Spencer finds me as I loop past Mad Mex and we head back to hospital to check in. The poor hubs is quite stressed out and shell-shocked. He thought we had another two weeks.



6.00 pm: We are brought to Room 7, our labor and delivery room, where we will remain until baby is born. I feel restricted as various monitors are strapped onto my belly (to monitor baby's heart rate and my contractions), my arm and finger (blood pressure and pulse), and a hep-lock put in (at my request, instead of an IV). The monitors show baby's heart rate to be normal, and lots and lots of contractions, which feel like mild period cramps. The nurses assure me that the monitors are temporary, and the midwife on duty - who so happily happens to be Tanya (who has seen me throughout my pregnancy) - will have them off when she comes in. Cara is my nurse for the night. I like her. She looks all of 14 years old (she's 24), and is cheerful and kind. Tanya carefully reads through my birth plan, and for most part it will be doable. No promises about pitocin-free, but she is willing to have me try other methods first. Every hour, I am confined to the bed for 15 minutes while the intermittent fetal monitor etc is strapped on to record. Penicillin is administered in two doses via the hep-lock and I wheel it with me while doing laps around the courtyard.

8.00 pm: Cervix check reveals I'm 3 cm (according to Tanya), and she suggests breaking my water bag, to which I agree. After that's done, I'm measuring 4 cm. She also suggests nipple stimulation and a shower, so I give that a go too. I keep Walking. The courtyard is now dark, and it's chilly. The contractions are stronger now - like one of my more severe period cramps - but I walk and breathe through them.

10.00 pm: Tanya is leaning toward starting the pitocin, but sees my reluctance. She suggests a membrane sweep, to which I readily agree. It is a little uncomfortable. I'm still only at 4.5 cm. I resume my Walking.

12.00 am: I'm at 5 cm and 75% effaced, which isn't the 95-100% effacement that Tanya was hoping for. Pitocin at low dose (2) is started shortly after. Knowing that I wish to be free to move during labor, Cara swaps out the fetal monitors for the portable ones but I have to remain on the pitocin drip. I do hip swivels on the birthing ball. I'm getting tired and sleepy as it's past my bedtime and I've been walking/moving for 12 hours now. But the pitocin kicks in and I won't be getting any sleep. Spencer lays down on the daybed and falls asleep.

I try to find a comfortable position, on my left side feels better than on my back. I focus on breathing oxygen to my uterus as it contracts. I remember the take-home message from Judy Jones' two Lamaze classes I managed to attend,

"The uterus is a HUGE muscle and therefore needs a lot of oxygen when working. Tensing other muscles in the body will take away from oxygen that should go to the uterus. Lack of oxygen will cause the uterus to cramp. These cramps are what hurts. So, completely relax your body, and breathe oxygen to your uterus, to avoid cramps and pain".

I also remember the positive messages from the Hypnobabies CDs that I have been listening to, "pressure waves that bring you closer to meeting your beloved baby".

The contractions become more intense as the hours pass, and I'm feeling it quite a bit in my back, but also on the front of my belly. I rest completely between contractions. I look over at Spencer, slumbering peacefully on the daybed. I don't know how much longer this will take, or how much more intense it will get. This uncertainty, and my tiredness, have me thinking of 'Epidural' once or twice.

2.30 am: Tanya checks and finds that I am 7 cm dilated, and appears pleased at my progress. She looks at my face during one of the contractions and comments that my ability to relax will go far to ease my birthing. Spencer wakes up and I get him to apply pressure on my back. It feels good to have his big hands press on my back. I feel most comfortable birthing on my hands and knees, on the bed. It's just him and I, for what seems a while. I notice that the contractions are getting much longer. Was that 90 seconds? And the breaks in between are getting shorter. I feel pressure building up against my vaginal wall. Is that her head descending? I feel a strong urge to push, and fight it by breathing hard. I don't know if I should push - what if I'm not completely dilated yet?

3.30 am: Cara checks in on me, and I tell her I feel like pushing. Tanya returns and finds I am 10 cm dilated! She tells me I can push! Spencer sets up the bars at the head of the bed, and I kneel upright, grabbing on to the bars and pushing with the aid of gravity. It feels so good to push. As baby gets closer, I switch to lying on my back at 45 deg, so that Tanya can do the perineal massage that will prevent tearing. Spencer adjusts the ceiling mirror, and I can see all that is going on. It feels surreal. Tanya coaches me, giving just the right words at the right time, "Now, I want you to bear down, hold it there, take a deep breath and keep pushing", I hear her say. "Work with your contractions, push when  you are contracting". I rest in between the contractions that are aiding my pushing efforts. Spencer tells me later that I smile at these times. Baby's head is having a little trouble getting past my pubic bone. Spencer and Cara each grab hold of either knee and help draw them back as far and as wide as they will go. This seems to do the trick - all of a sudden, I can see baby's hair! I can't take my eyes off her hair. I can't wait to meet her. With every push, she is closer to me. I see her head crown, and seconds later, she is in my arms, skin-on-skin, bawling really loudly. I turn to look at Spencer. I think he is teary eyed. I'm not crying though. I'm saying 'Oh.... oh... oh...." over and over again as I gaze at our baby. 7 lbs 3 oz, 20.75 inches.

She is perfect.

Time of birth 4.29 am.

I love you Meili Abigail Clark.