Monday, January 23, 2012

A Learning Experience; Evan's Birth Story

Today was my 6 week postpartum visit, so it's about time I finished this. I wrote most of it the morning after he was born, while I was still in the hospital. As a forewarning, it is long, and not very eloquently written.
I'm not happy with how it went, but I know that if I had to redo it, I wouldn't change anything really. Not on that day. But, next time things will go differently. Things will be better.

Evan Carlisle was born at 9:41pm, December 10th. He weighed 8 lbs 3 oz, and was 21 inches long.
I woke up at 8:45 in the morning from a contraction, and went back to bed, only to wake again at 8:59. I sat in bed, timing contractions for a little while, before waking my husband, Eddie, up. He wasn’t very happy, especially when I announced that we weren’t going anywhere just yet though.

I continued to have contractions about 7 minutes apart for most of the day, with some 5 minutes, and some as far as 15. I used the time to clean up, and get some last minute things done. Also, one of our cats was sick with no appetite, so we waited for that to be resolved first.

I drove myself to the hospital around 4:30. When they took me back to check me, they first explained how things would go. They would check dilation, then monitor the baby and contractions for half an hour, then have me walk for two hours, then check again. If no progress, I would be sent home.

So when she checked my dilation, she was really surprised. 6cm with a bulging bag of water, 90% effaced. I was definitely in labor. So she decided to skip over all that stuff she had just explained, and admit me. She also said they would probably want to break my water pretty soon. So we head over to the room I'm going to labor in, and the nurses are commenting that they're impressed, and I don't look like I'm 6cm in hard labor, because I'm walking fine, talking, just breathing through contractions. I also told her I wanted to avoid meds if I could, and she said that it seemed like I would be able to no problem.

We get to the room and they hook me up to monitor contractions and fetal heart rate. I'm told I'll only be on this for 20 minutes, but I never get taken off. I later learned that it was because his heart rate was dropping with contractions, but it wasn't "too bad" - they just wanted to keep an eye on it at this point. This definitely changed my plans, as I really wanted to be able to adjust and move around, but instead I was glued to the bed.

After I was set up, I had Eddie text my mom and brother finally that I was in labor at the hospital. Then the doctor comes in; not my normal doctor (or even from my practice) because he's covering for her until 10. He comments that not many people in hard labor are sitting up, laughing, texting, etc.

So he goes to check me before breaking my water, and I'm at 8cm. Progress, and all I've been doing is sitting. Awesome, and surprising.

He goes on to break the water, which wasn't bad. There was a gush of extremely warm liquid, and no obvious difference in contractions right away.

Contractions started to get more intense, but nothing unbearable. They also are getting closer together, but I really have no sense of how close.

I labor for awhile, being able to move a little - but I have to be careful not to disrupt the readings. I've also got two medical students, who are really excited because they've never witnessed a delivery.
I get checked again, still the same.

After awhile, things are a lot more intense. I get checked again. 8 and a half. So some progress. Labor gets a lot more intense when I get the shakes, because it's much more physically exhausting. After a bit they check again, and I'm at 9cm. I stayed at 9 for quite awhile, as contractions starting to run into each other. They wanted me to rock my hips in bed, but between the monitor, and still being limited to the bed, it just wasn't working well for me. The monitor kept getting shifted, so a nurse had to hold it on my stomach. 

They decided to place something on Evan’s head to monitor his heart rate, because I was moving too much for the one on my stomach to be accurate.

After another check where I was still at 9, I asked if I could have something for pain. I knew that I didn’t want to be stalled at a 9, and that if I could manage the pain, and get a break between contractions again, I could do what they needed me to so that things could get going again. Especially as they had now mentioned pitocin, and honestly, I didn't think contractions could get worse at this point (mostly because I was unable to get my bearings in between).

They said they didn't think they could give me anything, but they would check. After a little bit, they brought something in, along with pitocin. I was getting the narcotic, which was fine with me.

Now I could tell where my contractions began and ended, and I could adjust myself. After awhile, I still wasn't progressing well, so they upped the pitocin, and as the pain meds were wearing off, they gave me twice as much as they had before. And no, I wasn’t asked before they did this.

Also, somewhere in between, I had been told if I felt I needed to push, let them know. Then my doctor came in early, so she was going to be able to deliver. The rest is a bit fuzzy, and may be out of order.

I was out of it now, either in pain, or sleepy, and she wanted me to try pushing. I wasn't doing well, because I didn't feel an urge. I even told them it was only intermittent. They were pretty insistent, but I refused to push for an hour - then I finally got the urge! Apparently he had been posterior the whole time (we knew that because of u/s three weeks ago, and back pain I had been having), but had rotated. During the rotation, because of how his head was placed, I wasn't feeling the urge consistently. So basically, it was a good thing I waited. Honestly, it felt like something was wrong when I tried to push before. Granted, how I vocalized that was "it hurts" to which they said it would only stop if I pushed him out, and I responded with "no"... They probably thought I was crazy.

Once I was pushing, I was totally out of it. My eyes were closed pretty much the whole time. It was 3 or 4 good pushes, with a break halfway through for oxygen... which I noticed they put on me at some point, but I have no clue when. It was a lot of work, but I made sure to "hold" the pushes in between, in an attempt to not let him slide back in. I just wanted to be done.

Then I heard my doctor say she had to do an episiotomy, and I didn't care at that point. I thought I heard the cut, but I know I didn't feel it.

When he came out, it was like time slowed down. My eyes were shut, and when I opened them, I was confused. They didn’t give him to me right away.

taken by Eddie when they whisked him away -  I still hadn't seen him at this point
His cord had been wrapped twice around his neck, and then his breathing wasn’t regular. Evan was over getting examined by the staff. They told me that they were going to take him for an hour to monitor his breathing, and I asked to see him. I still hadn’t seen him.
They let me see him for a second – but not hold him – then they took him off to the NICU.

taken by Eddie in the NICU, where he sat with him, while I slept in L&D
Before long, I was alone in the room. I texted my mom to let her know that he’d been born, and was going to be gone for an hour, and then I wanted time with him before she and my brother came back.

I was in and out of sleep until they finally brought him back to me. It had been longer than an hour. We attempted breastfeeding, and it seemed to go well, and then I was told that he would be taken back to the NICU for a bath and some tests. I wanted my husband to go with them, but he couldn’t. There was something emergent going on with a premie.

We were moved to the room we would spend the rest of our stay in, and then it was a waiting game. My mom found her way back to us, and I got to inform her that we didn’t have the baby yet. My brother and his girlfriend ended up going home around this time, because they had a long day and were exhausted. And we still had no idea when Evan would be back. My mom took my husband to get something to eat, and check on our cats, and then while I was alone, they brought Evan to me. It felt odd, to be perfectly honest.
I didn’t get any of those feelings people claim to get after they have a baby. I felt pretty disconnected from him for at least a day.

I’ve learned from my experience now. Because of the Nubain, he didn’t nurse effectively at the hospital, in addition to how it affected both him and I during his delivery. However, if I hadn’t had the Nubain, things could have gone worse. I could have ended up with a c-section, because I probably would have stayed stalled for awhile, plus his heart rate had been dropping with contractions.

Next time, I would like to have a doula, and have a written birth plan. I do appreciate that they didn’t push medication on me, until of course I asked for it. Overall, the pain wasn’t bad though, and I want to truly go natural next time.  I just need to remember that it’s just transition, and that it’s almost over, next time it gets that intense.

Meanwhile, Eddie’s mentioned that we should do a home birth next time. With our pets, that seems like a bad idea. But, I wouldn’t mind a non-hospital birthing center. Something more comfortable. And I would love to actually have some alone time with my husband during the next labor.

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