This post is long long long, but I left a lot of details out of Kermit's birth story, and I need to get them written down somewhere I can read them later. (But, I didn't want them integrated with his birth if they didn't have to be, because ick! let's focus on the cute baby for that one!) Details like, in what ways did it matter that I didn't give birth vaginally? How was the c-section? Did they put everything back where it goes, or is my bladder in a subtly different place than it was before?
The answers are: Lots of ways. It sucked. Things definitely feel a bit scrambled in there.
More details? Yes, I do have more details! If you insist.
First, I'll just mention that the nurses at my hospital are clearly not used to dealing with women who do not want a c-section, despite a non-trivial number of women attempting VBACs at this hospital on a regular basis. I can't possibly be the only woman they've ever dealt with who wanted a vaginal birth but didn't get one. And yet every nurse greeted me with something along the lines of, "You're here for your scheduled c-section! You must be very excited to be having surgery today instead of going through all the hassle of a vaginal birth!" When the first person said this, I didn't respond, because my eyes filled with tears and I didn't trust myself to speak. With the second person, I informed her that I actually would prefer the hassle, thankyouverymuch, but it didn't end up being feasible for me. I'm not sure how I expected her to respond to this... probably something like, "Oh, I'm sorry it didn't work out. We'll do our best to make this experience as positive for you as we can." That would have been reassuring. Instead, she tried to convince me that this way would be so much easier and more convenient for me. Which was exactly why I was upset, so it was exactly the wrong thing to say. Anyway, that nurse must have made a note in my file ("Crazy woman wanted VBAC instead of the nice convenient surgery") because every other nurse who came into my room, even ones who were just dropping off linens, gave me a speech that started with, "So I understand that you're a little reluctant about your c-section today" and then proceeded to tell me why surgery was oh so very convenient. In a voice that very much implied that only a naive little girl would be reluctant to give birth surgically.
Blech.
I'm definitely not a granola hippie type person, and I've always shrugged off people who believe that giving birth in a hospital automatically means that you'll be steamrolled by the uncaring medical establishment, blah blah blah. That whole outlook on hospital births was nothing like my experience giving birth to LL -- I had a doctor who listened to me, provided me with well-researched information, and ultimately let me call the shots about my own care; I had supportive nurses who asked how I wanted to be treated with regards to labor assistance, and then followed through on my wishes; the default behavior at the hospital is that all babies room in with their mothers; fathers are considered on equal footing with mothers, and are thus not considered "guests," which means that they can always spend the night if they want to; it is assumed that all mothers will breast feed, and formula is never offered unless it is explicitly requested by the parents. Basically, everything that the anti-hospital-birth people complain about... none of it matched with my experience with LL. But hearing nurse after nurse try to convince me of the virtues of a c-section, when I very obviously did not want it... um, yeah, I get it now.
Anyway, once everything was set for the c-section, I managed to get myself into a good mental place where I just wanted to meet little Kermit, regardless of how it happened. The c-section was, ultimately, medically necessary, so let's just go ahead and do it. And as I mentioned in Kermit's birth story, my hospital actually does a lot of things to make it easier on c-section moms, so that they don't miss out on as much of the post-birth stuff. A lot of these polices were actually new since LL was born, so I was pleasantly surprised. For example, when LL was born, he was immediately whisked off to the nursery. The nurse held him up next to me for 10 seconds so that I could get a quick glimpse and S could snap a quick picture of me with him, and then I didn't see him for nearly an hour, during which he was weighed and examined and bathed and dressed and everything else they do during those first precious minutes. I hate the one photo I have of me with LL immediately after his birth. The nurse was holding him at an angle to get us both in the photo, but that meant that I couldn't actually see him at all. In the photo, I'm trying to smile for the photo, but it looks like a horrible grimace because I'm really attempting to crane my neck to see his face, which is exceedingly difficult to do while you're unable to move and someone two feet away is still holding your uterus outside of your body. This time around, I got to see him as he was being born. He was cleaned up ever so slightly, the bare necessity of stuff was done (apgar scores and very little else) and then he was brought immediately to my side, where I got to touch him and hold him and stroke his face for as long as I wanted. They didn't do anything else to him until after my surgery was over, so that I could take part. Fantastic improvement over LL's birth.
Before having this c-section, Dr. M had assured me that a lot of things would be better than LL's birth. Since this was a scheduled c-section, instead of an "OMG, after 23 hours of labor the baby is stuck like a big round peg in a much smaller pelvic opening and he's turning purple we have to get him out now" c-section, the surgery itself would be much easier. None of that "push the baby back out of the birth canal so we can reach him" stuff that made my recovery the first time oh-so-fun. None of the body trauma from the long labor and several hours of pushing. Easier surgery. Easier recovery. He promised.
To summarize: that was not my experience.
This c-section was definitely completely different than what I remember with LL, but not in a good way. The birth itself was very similar, but once the baby was out, things diverge tremendously. I remember feeling very little during the 30 minutes it took to close me up last time; I mostly remember being rather bored and wanting to get out of there so that I could see my baby. This time around, I was consumed with the terrible tugging and pulling going on at my lower half. It felt awful. It's hard to describe the sensation of your body being tugged and pulled in a million different directions, internally, while you're unable to move. I can't use the word "painful" because the spinal does block pain down there, but it was intensely uncomfortable and unsettling. I also started feeling dizzy, and out of the corner of my eye, I watched my own stats on the monitor to see my blood pressure dropping down down down.
The anesthesiologist offered to give me something to make me sleep through the rest of the surgery, but I declined, because I wanted to be completely alert as soon as they were done, so that I could nurse. A few minutes later, I started to experience horrible chest pain that got worse and worse. I panicked a bit because, um, what happened to not feeling any pain? The anesthesiologist added some other type of pain killer, which dulled it a bit (he promised it was referred pain, and not a heart attack, which is what it felt like) but it also made me even more dizzy, and my blood pressure continued to drop. The tugging and rummaging seemed to go on and on, as I repeatedly asked how many more layers they had to go. It really sucked. Which surprised me, because I expected the recovery to suck, but not the actual procedure. Over and over in my head was the thought that thank goodness Kermit was here and healthy, but this whole surgery thing was clearly a mistake. I just desperately wanted to be out of there.
When I finally got to recovery, all I wanted to do was to sit up and nurse Kermit. When they took my stats, though, they discovered that my blood pressure was still very very low, and my temperature was also low and continuing to drop. They would let me sit up a little, I would get very dizzy, and they would immediately lie me back down. Thus, my first nursing experience with Kermit involved me lying flat on my back with hot towels wrapped around my head in an effort to bring up my core body temperature. (It didn't work; when I left the recovery room two hours later, my body temp was still hovering near 95, which is a bit insane, and my blood pressure was barely double digits. In retrospect, I'm not sure how I was even conscious.)
I was in that condition for the rest of the day. My L&D nurse asked me what one thing she could do for me that would make my life better, and I said, "I want to get up and walk around!" Nope, not gonna happen. "How about at least letting me sit up?" And she looked at my stats, and smiled apologetically, and asked if there was anything she could do for me that wouldn't make me faint. (Side note: I'm lying in a bed with rails. Why does it matter if I faint? It's not like I'm going to fall into anything or bump my head, and I'm sure I'd come around again eventually. I'm kidding, but only barely.)
Anyway, the surgery sucked. I'm not a squeamish person; I can watch my own blood being drawn, and I have no fear of surgery or anesthesia or any of the rest of it. Yet the last 30 minutes or so of Kermit's c-section ended up being one of the more terrifying things I've ever been through, as the chest pain consumed me and my abdomen was pummeled from within and I thought I was going to pass out and my blood pressure dropped lower and lower. And the rest of that day, as I struggled to sit up despite continuing low blood pressure and low temperatures, also sucked.
The next morning, my stats were still low, but no longer in the scary range, and I was allowed to sit up and eat a little and get out of bed. After LL's birth, this was when things were just starting to suck, because the recovery from labor + surgery was long and hard. But I'd been promised that recovery this time around would be much easier, so part of me actually started feeling like maybe the worst was behind me. Except that my recovery was worse than last time, too, for unknown reasons. It does seem to have been faster -- I wasn't able to move around normally until 8 weeks last time, which meant two full months of no driving and no lifting things and trouble standing up or getting out of bed. This time around, I felt like I reached 85% recovery by the one-month mark, and I kind of ignored that last 15% and just returned to my life, so that was definitely an improvement. But that first month was much worse than last time. It's almost as if my two months of pain from last time was just intensified and shoved into a shorter period of time. Is that better and easier? Um.... not sure. I was definitely in a lot more pain for that entire month. But maybe it's just an indication that, last time, I got off easy.
I had my six weeks post-partum appointment last week, and I know that I'm definitely better now than I was at six weeks post-partum with LL, so I guess that's something. And the remaining effects from the surgery (loss of nerve sensitivity for several inches around the incision; intense pain on my lower left side when I do anything more strenuous than walk from the living room to the bathroom; extremely weak ab muscles that give out when I carry Kermit for more than five minutes) are apparently completely normal, and can be expected to continue for another 4-6 weeks.
So, overall, while I'm thrilled that Kermit is here and healthy (recent hospitalization for respiratory distress aside), and that I will eventually be completely healthy as well, I can't say that things went as I expected. And while I'm grateful that c-sections are an option -- having a c-section certainly saved both my life and LL's life two years ago -- I'm left wondering why the hell anyone would choose a surgical birth voluntarily. S and I haven't decided yet whether we will someday want to try to have a third child, but I hate beyond measure that my birth experience with Kermit is inevitably going to color that decision for us.
Showing posts with label birth. Show all posts
Showing posts with label birth. Show all posts
Friday, February 25, 2011
Wednesday, February 16, 2011
Kermit's Birth Story
I've obviously been distracted for a while now, what with the extra work of keeping my kids out of the hospital and stuff, but I didn't want to wait much longer to get Kermit's birth story written down. So here it is, in way too much detail, the story of Kermit's entry into the world.
We had a relatively normal morning, getting LL ready for the day. I had become ridiculously emotional the night before, and that continued into the morning. Every time I tried to talk to LL, I started crying. I'm honestly not even sure why. But I kept sitting down with him on my lap to try to explain to him what was going to be happening over the next few days, and every single time, I had to do it through tears. We'd spent the last two weeks having these conversations once or twice a day, where I would explain to him that very soon, Mommy and Daddy were going to go away for a few days, and he would get to stay home and play with Grandma and Grandpa. Grandma would dress him and change his diapers and read to him and rock him and put him down for bed and feed him (even special treats like yogurt shakes and french fries!) and it would be tons of fun. And after a few days, Mommy and Daddy would come back home again, because even though Mommy and Daddy leave sometimes, Mommy and Daddy always come back home. Each time I explained this to him, he would nod his head and say that he understood, and I just hoped that after hearing it a dozen times, it would actually sink in. So, I gave him my speech one final time, through a few tears, and he nodded his head and patted my leg and asked if the baby was coming home. All good. After breakfast, my mom drove LL to Natasha's at more or less the normal time, and he waved and blew me kisses from the car as they drove away. S and I took a few minutes to finish packing up our stuff, and at 10:00, we left for the hospital.
After an emotionally tumultuous evening, I felt more and more calm the closer we got to the c-section. I still wasn't thrilled with how things were going, but I was slowly moving past the disappointment and focusing on the joy of finally meeting our little Kermit. We checked in at the hospital, got settled in an L&D room, and began all of the random things that you have to do to prepare for surgery. (Undress, sign forms, answer tons of questions in triplicate, start an IV.) The IV took several attempts by several people, and ultimately the anesthesiologist had to do it himself, and it took him two tries. One person remarked that it appeared that I did not have a circulatory system, though I assured her that I was fairly certain that I did. It reminded me of my ultrasound 3 weeks earlier, when the technician couldn't find my cervix. I had to reassure her, too, that I was fairly certain it was there, since the baby had not fallen out yet.
Eventually, S and I were left alone, as the IV pumped me full of fluids and we waited for the appointed time. I surprised myself by how calm I was by the time we moved to the operating room. Time to get the show on the road!
Getting the spinal was relatively easy, and I was shocked by how quickly it began to numb my legs. I literally felt the cold spread downwards as I slowly lost sensation. I wasn't quite prepared, though, for how much I was still able to feel. I seemed to recall my epidural at LL's birth blocking just about everything during the c-section -- even when I was warned to expect some pressure at the moment when they took him out, I only really noticed it because it moved my whole body a bit. This time, I spent the entire surgery completely aware that people were rummaging around inside of me. It wasn't painful exactly, but supremely uncomfortable and unsettling.
After 10 minutes or so, Dr. M announced that he was ready to get Kermit out. At my repeated insistent request, they lowered the curtain for me so that I could see him emerge, which was incredible. (I had asked Dr. M about this possibility several weeks ago, and he told me that it would be fine, but to remind him on the day of the c-section. I mentioned it to the anesthesiologist when he was talking to me about the spinal that morning, and he balked and said, "No way!" I sputtered a bit and tried to get him to discuss it with me, but finally just dropped it until Dr. M came into the operating room, at which point I brought it up yet again. Dr. M immediately said, "Sure, that's fine!" and told the anesthesiologist to be sure to lower the curtain at the appropriate time. Score one for speaking up for yourself!)
I didn't get to see LL until after he was washed and swaddled, so it was wonderful for me to be able to see Kermit while he was still attached to his umbilical cord, all naked and alien gray and covered in schmutz, hands clenched in angry fists and squawking in surprise. And at that moment, his method of birth didn't matter. Or rather, it mattered, but it wasn't the earth-shattering disappointment that it seemed the day before. I'm still sad that it happened this way, and I feel like I still need to mourn never getting the opportunity to progress naturally and give birth vaginally, but seeing my brand new son in his very first second of life did indeed heal the worst of the resentment.
Kermit was cleaned up ever so slightly, the bare necessity of stuff was done (apgar scores and very little else) and then he was brought immediately to my side. The nurse supported his body while lying his head on my chest, allowing me to watch him and kiss him and stroke his face with my hand and count his fingers for as long as I wanted. And S and Kermit and I got to spend quite a while staring at each other and murmuring over our perfect little baby. When Kermit was put back in his bassinet, it was only to go with S to my recovery room, where S got to bond with him undisturbed while they waited for my surgery to end. Only after I joined them in the recovery room did the nurses do the rest of the post-birth stuff like weighing and bathing, so that I could observe everything.
Meanwhile, Dr. M and his team were putting me back together. I'm going to skip over that part for now, because it sucked. I'll leave the sucky things for a different post.
When I got to recovery, I asked for Kermit to be unwrapped so that I could hold him on my chest skin to skin while he was still all new and alert, something that I never got to do with LL until an hour or so later. The nurse wanted to bathe him, but cheerfully agreed when I said that I would prefer to nurse him first. And so I got to cuddle my naked little Kermit on my chest and watch him root and twist his way to my breast, where he latched on almost immediately.
After that, we did the usual things you do post-birth. Snuggled Kermit. Called the relatives. Chose a little knit hat for him to wear in the hospital. Remarked about who he looks like (more S than me, but just barely) and what color his eyes are (steely gray) and the incredible quantity of hair (dark and curly, as expected).
The extra fun ending to the birth story: once we were all moved from recovery into the room on the maternity ward where we would be staying for the next several days, our newly assigned nurse smiled at the three of us and said, "All settled?" At which point, right on cue, we had an earthquake. Yes, an actual earthquake. I was on a wheeled hospital bed, so I thought that somebody had just kicked the bed really hard for no good reason, and I was a bit confused about why somebody would do something so mean to a woman who just had surgery, but then S looked around and asked if anyone else felt something, and we all realized what was going on. At the tender age of almost-exactly-three-hours old, Kermit experienced his first earthquake. A magnitude 4.1, for those of you keeping score at home. That number will either make you say, "Wow, that sounds big!" or "Wow, I'm surprised you felt it at all!" depending on whether you've ever lived around earthquakes and how well you understand logarithms.
Welcome to the world, Kermit! Life is full of surprises.
We had a relatively normal morning, getting LL ready for the day. I had become ridiculously emotional the night before, and that continued into the morning. Every time I tried to talk to LL, I started crying. I'm honestly not even sure why. But I kept sitting down with him on my lap to try to explain to him what was going to be happening over the next few days, and every single time, I had to do it through tears. We'd spent the last two weeks having these conversations once or twice a day, where I would explain to him that very soon, Mommy and Daddy were going to go away for a few days, and he would get to stay home and play with Grandma and Grandpa. Grandma would dress him and change his diapers and read to him and rock him and put him down for bed and feed him (even special treats like yogurt shakes and french fries!) and it would be tons of fun. And after a few days, Mommy and Daddy would come back home again, because even though Mommy and Daddy leave sometimes, Mommy and Daddy always come back home. Each time I explained this to him, he would nod his head and say that he understood, and I just hoped that after hearing it a dozen times, it would actually sink in. So, I gave him my speech one final time, through a few tears, and he nodded his head and patted my leg and asked if the baby was coming home. All good. After breakfast, my mom drove LL to Natasha's at more or less the normal time, and he waved and blew me kisses from the car as they drove away. S and I took a few minutes to finish packing up our stuff, and at 10:00, we left for the hospital.
After an emotionally tumultuous evening, I felt more and more calm the closer we got to the c-section. I still wasn't thrilled with how things were going, but I was slowly moving past the disappointment and focusing on the joy of finally meeting our little Kermit. We checked in at the hospital, got settled in an L&D room, and began all of the random things that you have to do to prepare for surgery. (Undress, sign forms, answer tons of questions in triplicate, start an IV.) The IV took several attempts by several people, and ultimately the anesthesiologist had to do it himself, and it took him two tries. One person remarked that it appeared that I did not have a circulatory system, though I assured her that I was fairly certain that I did. It reminded me of my ultrasound 3 weeks earlier, when the technician couldn't find my cervix. I had to reassure her, too, that I was fairly certain it was there, since the baby had not fallen out yet.
Eventually, S and I were left alone, as the IV pumped me full of fluids and we waited for the appointed time. I surprised myself by how calm I was by the time we moved to the operating room. Time to get the show on the road!
Getting the spinal was relatively easy, and I was shocked by how quickly it began to numb my legs. I literally felt the cold spread downwards as I slowly lost sensation. I wasn't quite prepared, though, for how much I was still able to feel. I seemed to recall my epidural at LL's birth blocking just about everything during the c-section -- even when I was warned to expect some pressure at the moment when they took him out, I only really noticed it because it moved my whole body a bit. This time, I spent the entire surgery completely aware that people were rummaging around inside of me. It wasn't painful exactly, but supremely uncomfortable and unsettling.
After 10 minutes or so, Dr. M announced that he was ready to get Kermit out. At my repeated insistent request, they lowered the curtain for me so that I could see him emerge, which was incredible. (I had asked Dr. M about this possibility several weeks ago, and he told me that it would be fine, but to remind him on the day of the c-section. I mentioned it to the anesthesiologist when he was talking to me about the spinal that morning, and he balked and said, "No way!" I sputtered a bit and tried to get him to discuss it with me, but finally just dropped it until Dr. M came into the operating room, at which point I brought it up yet again. Dr. M immediately said, "Sure, that's fine!" and told the anesthesiologist to be sure to lower the curtain at the appropriate time. Score one for speaking up for yourself!)
I didn't get to see LL until after he was washed and swaddled, so it was wonderful for me to be able to see Kermit while he was still attached to his umbilical cord, all naked and alien gray and covered in schmutz, hands clenched in angry fists and squawking in surprise. And at that moment, his method of birth didn't matter. Or rather, it mattered, but it wasn't the earth-shattering disappointment that it seemed the day before. I'm still sad that it happened this way, and I feel like I still need to mourn never getting the opportunity to progress naturally and give birth vaginally, but seeing my brand new son in his very first second of life did indeed heal the worst of the resentment.
Kermit was cleaned up ever so slightly, the bare necessity of stuff was done (apgar scores and very little else) and then he was brought immediately to my side. The nurse supported his body while lying his head on my chest, allowing me to watch him and kiss him and stroke his face with my hand and count his fingers for as long as I wanted. And S and Kermit and I got to spend quite a while staring at each other and murmuring over our perfect little baby. When Kermit was put back in his bassinet, it was only to go with S to my recovery room, where S got to bond with him undisturbed while they waited for my surgery to end. Only after I joined them in the recovery room did the nurses do the rest of the post-birth stuff like weighing and bathing, so that I could observe everything.
Meanwhile, Dr. M and his team were putting me back together. I'm going to skip over that part for now, because it sucked. I'll leave the sucky things for a different post.
When I got to recovery, I asked for Kermit to be unwrapped so that I could hold him on my chest skin to skin while he was still all new and alert, something that I never got to do with LL until an hour or so later. The nurse wanted to bathe him, but cheerfully agreed when I said that I would prefer to nurse him first. And so I got to cuddle my naked little Kermit on my chest and watch him root and twist his way to my breast, where he latched on almost immediately.
After that, we did the usual things you do post-birth. Snuggled Kermit. Called the relatives. Chose a little knit hat for him to wear in the hospital. Remarked about who he looks like (more S than me, but just barely) and what color his eyes are (steely gray) and the incredible quantity of hair (dark and curly, as expected).
The extra fun ending to the birth story: once we were all moved from recovery into the room on the maternity ward where we would be staying for the next several days, our newly assigned nurse smiled at the three of us and said, "All settled?" At which point, right on cue, we had an earthquake. Yes, an actual earthquake. I was on a wheeled hospital bed, so I thought that somebody had just kicked the bed really hard for no good reason, and I was a bit confused about why somebody would do something so mean to a woman who just had surgery, but then S looked around and asked if anyone else felt something, and we all realized what was going on. At the tender age of almost-exactly-three-hours old, Kermit experienced his first earthquake. A magnitude 4.1, for those of you keeping score at home. That number will either make you say, "Wow, that sounds big!" or "Wow, I'm surprised you felt it at all!" depending on whether you've ever lived around earthquakes and how well you understand logarithms.
Welcome to the world, Kermit! Life is full of surprises.
Saturday, January 8, 2011
He's Here!
Our son, Kermit*, was born Friday, January 7, at 1:00pm, via completely predictable c-section. He weighed a modest 7 lbs 7 oz, he's 21" long, and he's the best eater in the world. Seriously, this kid cannot stop eating.
Everyone is doing well so far, though I still have my cough left over from the cold a few weeks ago, and fits of coughing immediately after abdominal surgery sucks more than I can possibly describe. We should be home sometime early next week, and I'll write up a full birth story then. For now, I'll just mention that Kermit's birth was so earth-shattering that it culminated in an earthquake. Literally. A small one, but the building moved, and S and two nurses and I all looked at each other in disbelief and asked, "Wow, was it just me, or did anyone else feel that?!?" at the same time. I've lived in earthquake territory for nearly a dozen years, and I've felt maybe 6 earthquakes total during that time. Yet one of them was the night S proposed to me, and another one was the week we found out that we were pregnant with LL. And now this one to herald in Kermit's birth. Nothing inflates your view of your own significance quite like the universe moving a planet to announce your major life changes.
* As with LL, I have decided not to actually include Kermit's name on the blog, but I'll leave enough clues that you can easily figure it out if you want to. For blog purposes, the name Kermit has grown on me quite a bit, so we'll stick with that for now. In real life, his name starts with a J, and means "dove" in Hebrew. The name comes from a prophet in the Torah known most notably for being eaten by a very large fish.
Everyone is doing well so far, though I still have my cough left over from the cold a few weeks ago, and fits of coughing immediately after abdominal surgery sucks more than I can possibly describe. We should be home sometime early next week, and I'll write up a full birth story then. For now, I'll just mention that Kermit's birth was so earth-shattering that it culminated in an earthquake. Literally. A small one, but the building moved, and S and two nurses and I all looked at each other in disbelief and asked, "Wow, was it just me, or did anyone else feel that?!?" at the same time. I've lived in earthquake territory for nearly a dozen years, and I've felt maybe 6 earthquakes total during that time. Yet one of them was the night S proposed to me, and another one was the week we found out that we were pregnant with LL. And now this one to herald in Kermit's birth. Nothing inflates your view of your own significance quite like the universe moving a planet to announce your major life changes.
* As with LL, I have decided not to actually include Kermit's name on the blog, but I'll leave enough clues that you can easily figure it out if you want to. For blog purposes, the name Kermit has grown on me quite a bit, so we'll stick with that for now. In real life, his name starts with a J, and means "dove" in Hebrew. The name comes from a prophet in the Torah known most notably for being eaten by a very large fish.
Monday, December 6, 2010
Labor Anxiety
People have started asking me whether I'm nervous about labor and delivery, and I'll admit that I've been giving it a lot of thought lately. I'm actually not all that nervous about the actual labor and delivery part. I feel like I remember a fair amount about my labor with LL, and I don't feel like I'm being selective about what I remember. I remember some goods things (the anticipation; the growing excitement as things progressed; a sense of adrenalin-induced empowerment that I didn't really expect to feel once I started pushing; the incredible sound of his first cry) and of course, lots of things that were perhaps necessary but not what I would classify as "good" (frustration at the slow progression of early labor; annoyance that I couldn't walk around much; fear and disappointment when we found out that a c-section was necessary; and of course holy crap I remember a whole lot of pain). Overall, though, it wasn't a process that I dread going through a second time, though I am hoping for some fairly significant differences this time around.
During my pregnancy with LL, I spent much of my third trimester consumed with thoughts of labor. I'm not sure the right word to use. Not fear. Not dread. Anxiety? Let's just say that I was really really worried about it, because everyone seems to rank it as the most painful thing in the world and you don't know how long it's going to last and I had no idea what the pain was going to be like so my mind started inventing all sorts of crazy scenarios. This time? I'm honestly not all that worried about the actual labor and delivery. I'm bizarrely looking forward to it, actually, since I'm so excited to possibly do it without pitocin this time. And maybe even successfully deliver a baby without a c-section! This time around, rather than something to bring about anxiety, it just feels like a challenge. I can handle a challenge.
Having said that, there is something that I am feeling completely anxious and panicky about: how LL will handle my time in the hospital. I'm getting very freaked out about this. I have never spent a night away from LL, much less 3 or 4. LL has been put to bed by other people (grandparents, babysitters) but I have always been there when he wakes up in the morning. Things that are currently keeping me up at night:
1. Making sure that LL is taken care without too much panic if/when I go into labor. The possibility of going into labor during the holidays is making this particularly stressful. My mom has agreed to fly into town when I'm just short of 38 weeks, so that she can stay at our house and care for LL if I do go into labor, which is fantastic, but now I'm obsessing about what happens if I go into labor before she arrives. It's ridiculous because LL had to be induced at almost 42 weeks, and I'm suddenly worried about going into natural labor at 37 weeks, but still... I can't get it out of my head. We have a few friends lined up to possibly come to our house and stay with LL for a few days, but it would be very stressful for LL and that makes it very stressful for me.
2. If I do end up with a c-section, I'll need to be in the hospital for four days. That seems like a very long time to be away from LL. More and more, the main reason that I'm hoping for a VBAC is just so that I can get home sooner.
3. Another problem with a repeat c-section: when LL was born, I wasn't able to pick LL up out of his bassinet for at least a week, possibly two. I wasn't able to change his diaper for the first week, either. Every time I wanted to hold him, to feed him, to comfort him, someone had to pick him up and gently hand him to me. That was annoying but manageable, because S stayed with me in the hospital and did all of the baby-lifting for those first several days. This time around, we think that it would be easier on LL if S spent nights at home, so that he's around for LL's morning routine. But I don't know how I manage to care for Kermit overnight, including all those night feedings and diaper changes, if S isn't with me. As far as I can tell, my only option will be to let the nurses bring Kermit to the nursery after S leaves, but that kills breast feeding. So I'm kind of at a loss. If I have a c-section, it seems like S will have to stay at the hospital, and I worry about how LL will handle us both not being there in the morning.
4. I can't decide whether LL should visit me in the hospital or not. Does that make things easier or harder? On the one hand, I'm sure that he'll want to see me (and I'll want to see him!). On the other hand, what happens when he realizes that he needs to leave with Grandma and I'm not coming with him? Will that just make it harder?
5. Last week, I had an evening filled with lots of suddenly strong contractions. They eventually died down, and I was fairly certain the whole time that they were Braxton-Hicks and not the real thing. Nevertheless, they were shockingly strong and frequent, and I had to carefully breathe through them. I wasn't yelling or anything, but I was grimacing from the pain. And WOW, it freaked LL out. He kept coming over to pat my leg and talk to me and give me kisses, but mostly he just stared at me with a frightened look on his face. I kept reassuring him that Mommy was fine, everything was okay, but he was really very concerned. So now I'm worried about how he'll handle it when I'm in real labor but haven't left for the hospital yet. I guess from this perspective, it would be best if I went into labor in the middle of the night while he was sleeping, so that he wouldn't have to see me in pain, but I hate that then I won't be able to say goodbye to him before we leave.
So, yes, I'm worried about labor, but not for any of the reasons that I was worried the first time. And when I write them down, even these things seem very minor. Women manage to have babies without completely scarring and traumatizing their toddlers all the time. Things just work out. But I'm agonizing about it nonetheless.
During my pregnancy with LL, I spent much of my third trimester consumed with thoughts of labor. I'm not sure the right word to use. Not fear. Not dread. Anxiety? Let's just say that I was really really worried about it, because everyone seems to rank it as the most painful thing in the world and you don't know how long it's going to last and I had no idea what the pain was going to be like so my mind started inventing all sorts of crazy scenarios. This time? I'm honestly not all that worried about the actual labor and delivery. I'm bizarrely looking forward to it, actually, since I'm so excited to possibly do it without pitocin this time. And maybe even successfully deliver a baby without a c-section! This time around, rather than something to bring about anxiety, it just feels like a challenge. I can handle a challenge.
Having said that, there is something that I am feeling completely anxious and panicky about: how LL will handle my time in the hospital. I'm getting very freaked out about this. I have never spent a night away from LL, much less 3 or 4. LL has been put to bed by other people (grandparents, babysitters) but I have always been there when he wakes up in the morning. Things that are currently keeping me up at night:
1. Making sure that LL is taken care without too much panic if/when I go into labor. The possibility of going into labor during the holidays is making this particularly stressful. My mom has agreed to fly into town when I'm just short of 38 weeks, so that she can stay at our house and care for LL if I do go into labor, which is fantastic, but now I'm obsessing about what happens if I go into labor before she arrives. It's ridiculous because LL had to be induced at almost 42 weeks, and I'm suddenly worried about going into natural labor at 37 weeks, but still... I can't get it out of my head. We have a few friends lined up to possibly come to our house and stay with LL for a few days, but it would be very stressful for LL and that makes it very stressful for me.
2. If I do end up with a c-section, I'll need to be in the hospital for four days. That seems like a very long time to be away from LL. More and more, the main reason that I'm hoping for a VBAC is just so that I can get home sooner.
3. Another problem with a repeat c-section: when LL was born, I wasn't able to pick LL up out of his bassinet for at least a week, possibly two. I wasn't able to change his diaper for the first week, either. Every time I wanted to hold him, to feed him, to comfort him, someone had to pick him up and gently hand him to me. That was annoying but manageable, because S stayed with me in the hospital and did all of the baby-lifting for those first several days. This time around, we think that it would be easier on LL if S spent nights at home, so that he's around for LL's morning routine. But I don't know how I manage to care for Kermit overnight, including all those night feedings and diaper changes, if S isn't with me. As far as I can tell, my only option will be to let the nurses bring Kermit to the nursery after S leaves, but that kills breast feeding. So I'm kind of at a loss. If I have a c-section, it seems like S will have to stay at the hospital, and I worry about how LL will handle us both not being there in the morning.
4. I can't decide whether LL should visit me in the hospital or not. Does that make things easier or harder? On the one hand, I'm sure that he'll want to see me (and I'll want to see him!). On the other hand, what happens when he realizes that he needs to leave with Grandma and I'm not coming with him? Will that just make it harder?
5. Last week, I had an evening filled with lots of suddenly strong contractions. They eventually died down, and I was fairly certain the whole time that they were Braxton-Hicks and not the real thing. Nevertheless, they were shockingly strong and frequent, and I had to carefully breathe through them. I wasn't yelling or anything, but I was grimacing from the pain. And WOW, it freaked LL out. He kept coming over to pat my leg and talk to me and give me kisses, but mostly he just stared at me with a frightened look on his face. I kept reassuring him that Mommy was fine, everything was okay, but he was really very concerned. So now I'm worried about how he'll handle it when I'm in real labor but haven't left for the hospital yet. I guess from this perspective, it would be best if I went into labor in the middle of the night while he was sleeping, so that he wouldn't have to see me in pain, but I hate that then I won't be able to say goodbye to him before we leave.
So, yes, I'm worried about labor, but not for any of the reasons that I was worried the first time. And when I write them down, even these things seem very minor. Women manage to have babies without completely scarring and traumatizing their toddlers all the time. Things just work out. But I'm agonizing about it nonetheless.
Wednesday, October 15, 2008
Birth Story
I've been writing down notes on my labor and delivery for several weeks (3 weeks, in fact), and have finally gotten everything together. It's long, but I wanted to remember what happened, so feel free to skip sections (or the entire post) if it's boring.
We were supposed to call the hospital Thursday morning at 6:30am, to hopefully be to the hospital by 7:00 to start the induction. Our bags were totally packed, I had eaten the suggested "very light breakfast" (just a bowl of cereal), everything we needed was sitting in the car... we were ready to go! Instead, when we called, they told us to check back in a few hours. We called again at 8:30am, then again at 1:30pm, but they were still too busy to let us come to the hospital. We waited at home, with S doing random chores around the house and me watching movies to try to distract myself. At 3:30pm, we finally got the call from the hospital saying that we could come in. Finally, we were off!
We got to the hospital around 4:00. They immediately hooked me up to monitors for contractions and baby's heart rate, while asking me lots of intake questions and having me sign lots of forms. Much like the NST on Monday, the baby went back and forth between periods of reactivity and non-reactivity. A lot of the time, his heart rate would stay completely stable, not reacting at all to movement or contractions, even when the nurse "buzzed" him to try to wake him up. For short periods, he would react a little, but his heart rate stubbornly refused to go over the minimum threshold of 15 bpm above baseline. For a while, we weren't sure whether they were even going to go forward with the induction, but they eventually decided that he was "reactive enough" and they started the pitocin, letting us know that unless his reactivity improved, they would be upping the pitocin at a slower rate than usual, to avoid undue stress. Before starting, they checked my cervix, and everything was exactly as it had been the week before: just over 1cm dilated, 70% effaced, -2 station.
Despite the relatively low pitocin levels, after only 2 hours of pitocin, my contractions were coming every 2 minutes or less, lasting for 60 seconds each, and were already fairly strong. At that rate, I was getting basically no rest at all between contractions. I couldn't really concentrate on anything, but had the television on in the background to try to distract myself. I was also getting tired already, from not eating all day while waiting to be induced.
The nurses at our hospital believe in doing cervical checks as infrequently as possible, so I wasn't checked until 10:30pm, after more than five hours of labor. A new nurse had come on at 10:00pm, and she introduced herself by saying, "I'm Rachel, and I'll be the nurse delivering your baby! Well, actually, probably not, because you're really not going to be ready in 8 hours when I'll be going home." Hearing that you've got more then 8 hours to go, after you've already been contracting non-stop for 3-4 hours, is extremely discouraging, but it's even worse when it's said with such confidence despite never actually checking whether I was progressing. I asked her how she knew I wasn't progressing if nobody had checked, and she told me it was because I was still "too chipper." This pissed me off immensely at the time, but it turned out she was totally right -- I wouldn't be that chipper again for a very long time. And when she did check me at 10:30pm, I had made no progress at all, still only 1cm dilated.
I spent the next hour being extremely discouraged. My pain was increasing with each contraction, but I no longer believed that they were being at all productive. The nurse asked me if I wanted a narcotic pain killer, but I was determined to hold off on medication until I could do an epidural at 3cm. Instead, I wanted to try the other coping techniques I had planned on. Could I take a warm shower or bath? No, because they needed to continue monitoring my non-reactive baby, and the monitor couldn't go in the water. Could I walk through the hallways? No, because they couldn't switch me to the telemetry monitors because they weren't as sensitive, and they didn't want to miss something if the baby started experiencing further distress. They allowed me to pace back and forth within reach of the monitors (about 4 steps in each direction) which was of very limited help -- it basically left me feeling like a caged animal, which does very little to decrease pain and anxiety. I refused to get into bed, because lying down was excrutiatingly uncomfortable, so I alternated between pacing my 4 steps and sitting in a rocking chair for hours at a time.
S fell asleep around this time, and I was sitting alone in the labor room trying to breathe through contractions that were coming immediately on top of each other with no relief. By 1:15am, I was at the end of my rope from the pain. I called the nurse and told her that I needed the narcotic, which was administered at 1:30. It was supposed to last an hour, but I only got 45 minutes of partial relief. At 2:30am on the dot, I asked for a second dose. This one was even less effective, providing very limited relief and wearing off entirely by 3:00am.
S had woken up by this time, but no longer had any idea how to help. My pain for the last several hours had been a 10 on the 1-10 pain scale, and I was reaching the point where I didn't think I'd be able to cope. The nurse told me that I was allowed only one more dose of the narcotic, but she wanted to check my cervix again before giving it to me, since it hadn't been checked in the past 5 hours. She checked at 3:30, and low and behold, I had progressed to 3cm. Adding only 2cm during 5 hours of excruciating pain was discouraging, but it also had brought me to the point of "qualifying" for an epidural, so all wasn't lost. The nurse asked if I wanted an epidural now, and I gasped "Yes, yes yes!" over and over. The anesthesiologist arrived quickly, and the nurse went off to get a last narcotic dose to help me to stay still while the epidural was put in. (This was actually the most annoying part -- the nurse got locked out of the computer while trying to get the narcotic, which left me and S alone with an extremely shy anesthesiologist for what seemed like ages, with him holding the epidural drugs I was so desperately waiting for while he mumbled apologies that he couldn't give them to me yet.) Once he was able to start, however, the administration of the epidural was actually MUCH easier than I expected, and I was gratefully feeling the pain lessen dramatically by 4:30am.
The pain had largely returned by 7:30. The nurse determined that I probably needed a boost to my epidural, but first decided to check my cervix one more time. I had progressed a bit more, to somewhere in the 4-5 cm range, but more importantly, my water broke as she was checking, which promised to bring along faster progress. An internal monitor was placed on the baby's head (a big relief to me, since I meant one fewer strap around my belly -- those straps had been on continuously since the previous afternoon, and I hated them with a passion). Then, I was okay'ed for the epidural boost, this time from a different anesthesiologist. This event turned into the most surreal part of the delivery.... I THINK that the anesthesiologist was simply trying to confirm that the extra medication was working by asking me questions and judging how coherent my answers were. At least, I like to think that's what he was doing. I'm pretty sure that's how he started anyway. He asked where I worked. He asked what kind of work I do. I answered each question, and eventually assured him directly that I was feeling much better, the medication was working, everything seemed much better. But, rather than leave, he told me that he was fascinated by artificial intelligence, and started asking me in-depth questions about my research. Um... okay. I'd been having non-stop, no-break contractions for more than 12 hours at this point, and as much as I love my research, this wasn't really the time or place to be discussing it. When he switched from mild interest to actually challenging the research itself (my "favorite" of his questions: "But how would you know if it were really intelligent?") I was done playing along. I gave some sort of clipped answer in my best leave-me-alone-already voice, then turned to S and pretended the anesthesiologist no longer existed. I'm still shaking my head that the conversation ever happened. I really did not expect to be doing a thesis defense dry-run while in labor....
The next 4 hours are kind of a blur, but by 11:30am, it was time to check my cervix again. Yet another nursing shift change had happened, and I no longer believed that it was possible for me to have progressed more than a centimeter or two. To my surprise, the new nurse announced that there was no cervix left at all -- fully dilated and effaced. Finally! He called the doctor to check me to be sure that things were looking good (both me and my non-reactive baby), but told me to wait to start pushing until the baby dropped a bit more, because he was still quite high in my pelvis. We sat in that holding pattern for more than an hour. The baby was still having periods of non-reactivity, but overall looked good. He still hadn't dropped, but since he seemed to be holding up okay, they decided to have me start pushing, even though I'd be pushing him a very long way. Starting to push was fine with me -- after sitting around being fairly passive for so long, I was anxious to take a more active role.
The nurse was able to verify that I was pushing effectively and fairly strongly, especially given the epidural, which was still partially numbing my lower half. After 45 minutes of pushing, he checked to see how much the baby had advanced. He felt around for a while, then felt around some more, then frowned and checked even more. Eventually he came around to the side of the bed and explained the situation. He had felt all the way around the baby's head, which was firmly lodged in my pelvic opening. Normally at that stage, they feel around the head to see how many finger-widths they could fit between the head and the pelvic bone, to get a sense of whether the baby will need to turn at all to fit through. In my case, the baby's head was firmly against the bone all the way around, making direct contact around the entire circumference. And this was NOT the widest part of the head.
I remember trying to process this information, asking the nurse what that would ultimately mean. The answer: the baby was not coming out this way -- I would need a C-section. S and I looked at each other, and I could see concern and fear in his eyes. We asked a lot of questions, but it mainly came down to this: I could keep pushing if I wanted to, and it was theoretically possible that the head would deform enough to fit through, but the odds of it working out were very slim. (We were asking so many questions that, at one point, he looked at us and said, "Look -- this is a fairly common procedure, but you do need to understand that it is major abdominal surgery. It's not something simple like knee surgery." S and I looked at each other and burst out laughing, which confused the nurse until we explained that S had knee surgery less than a year ago, and the recovery sucked, and he's still not 100%. As I've been recovering these last few weeks, our constant refrain is, "Take it easy and give it time -- it's not something simple like knee surgery!") Anyway, at that point the nurse left us alone to talk while he went to get the doctor to verify his conclusion.
When the doctor checked, and confirmed the cephalopelvic disproportion (CPD -- a fancy way of saying "big head, small pelvis"), we asked her the same questions, and essentially got the same answers. I could keep pushing if I wanted, but it would probably not help. But there was one thing that I just couldn't get past: I wasn't exhausted yet. I was a little tired, but I had gotten quite the hormone-induced energy surge when I started pushing, and I hadn't used up all that adrenalin yet. If I gave in to a C-section (and yes, it really felt like it would be giving in) before I was truly exhausted, I was afraid that I would always feel like I gave up. I told the doctor that I was feeling pretty good, and we wanted to keep trying, for another hour or so. Her response: "Okay, we'll let you give it the ole 'college try,' but we'll need to recheck you at the two hour mark." So, I kept pushing.
When we reached the point of 2+ hours, the nurse checked again. The baby hadn't moved at all -- his head was still firmly lodged in exactly the same place. The only change was that the baby's head was starting to swell "alarmingly" (his word) from the unrelieved pressure, and he was showing more and more signs of distress on the monitor. I still had some energy to spare, but the stress on the baby clearly outweighed my desire to deliver how I wanted. I squeezed S's hand, and agreed to go ahead with the C-section.
After that, things moved very quickly. Forms were signed, belongings were moved to a recovery room, S changed into scrubs, and I was wheeled down the hallway to the obstetrics operating room. I was introduced to my third anesthesiologist, who went along with my request to keep up a running commentary on what the heck was going on behind that annoying blue screen. After just a few minutes, I was told that I would feel pressure, like someone was sitting on my abdomen. That pressure was quickly followed by several baby cries, the best sound in the world -- the arrival (finally!) of our LL. He was quickly rushed off to the nursery, with S in hot pursuit, leaving me in the operating room to listen to my (female) surgeon and (female) anesthesiologist discuss how awesome it was that they had such great families and careers because they both have stay-at-home husbands. (Told ya I lived in a liberal, progressive area!) As they were finishing up, I asked how big the baby was. The surgeon's response: "They weigh him in the nursery, not here, so I don't know. But I'll tell you this: he sure wasn't small!"
Not small, indeed.
Coming up next: my attempt to get my posts caught up to the present day. Annoying confusion in the hospital; at home with 8 million out-of-town family members; the picture-perfect no-tears bris; settling in, complete with grandparent slave labor; and finally, the three of us alone as a family.
We were supposed to call the hospital Thursday morning at 6:30am, to hopefully be to the hospital by 7:00 to start the induction. Our bags were totally packed, I had eaten the suggested "very light breakfast" (just a bowl of cereal), everything we needed was sitting in the car... we were ready to go! Instead, when we called, they told us to check back in a few hours. We called again at 8:30am, then again at 1:30pm, but they were still too busy to let us come to the hospital. We waited at home, with S doing random chores around the house and me watching movies to try to distract myself. At 3:30pm, we finally got the call from the hospital saying that we could come in. Finally, we were off!
We got to the hospital around 4:00. They immediately hooked me up to monitors for contractions and baby's heart rate, while asking me lots of intake questions and having me sign lots of forms. Much like the NST on Monday, the baby went back and forth between periods of reactivity and non-reactivity. A lot of the time, his heart rate would stay completely stable, not reacting at all to movement or contractions, even when the nurse "buzzed" him to try to wake him up. For short periods, he would react a little, but his heart rate stubbornly refused to go over the minimum threshold of 15 bpm above baseline. For a while, we weren't sure whether they were even going to go forward with the induction, but they eventually decided that he was "reactive enough" and they started the pitocin, letting us know that unless his reactivity improved, they would be upping the pitocin at a slower rate than usual, to avoid undue stress. Before starting, they checked my cervix, and everything was exactly as it had been the week before: just over 1cm dilated, 70% effaced, -2 station.
Despite the relatively low pitocin levels, after only 2 hours of pitocin, my contractions were coming every 2 minutes or less, lasting for 60 seconds each, and were already fairly strong. At that rate, I was getting basically no rest at all between contractions. I couldn't really concentrate on anything, but had the television on in the background to try to distract myself. I was also getting tired already, from not eating all day while waiting to be induced.
The nurses at our hospital believe in doing cervical checks as infrequently as possible, so I wasn't checked until 10:30pm, after more than five hours of labor. A new nurse had come on at 10:00pm, and she introduced herself by saying, "I'm Rachel, and I'll be the nurse delivering your baby! Well, actually, probably not, because you're really not going to be ready in 8 hours when I'll be going home." Hearing that you've got more then 8 hours to go, after you've already been contracting non-stop for 3-4 hours, is extremely discouraging, but it's even worse when it's said with such confidence despite never actually checking whether I was progressing. I asked her how she knew I wasn't progressing if nobody had checked, and she told me it was because I was still "too chipper." This pissed me off immensely at the time, but it turned out she was totally right -- I wouldn't be that chipper again for a very long time. And when she did check me at 10:30pm, I had made no progress at all, still only 1cm dilated.
I spent the next hour being extremely discouraged. My pain was increasing with each contraction, but I no longer believed that they were being at all productive. The nurse asked me if I wanted a narcotic pain killer, but I was determined to hold off on medication until I could do an epidural at 3cm. Instead, I wanted to try the other coping techniques I had planned on. Could I take a warm shower or bath? No, because they needed to continue monitoring my non-reactive baby, and the monitor couldn't go in the water. Could I walk through the hallways? No, because they couldn't switch me to the telemetry monitors because they weren't as sensitive, and they didn't want to miss something if the baby started experiencing further distress. They allowed me to pace back and forth within reach of the monitors (about 4 steps in each direction) which was of very limited help -- it basically left me feeling like a caged animal, which does very little to decrease pain and anxiety. I refused to get into bed, because lying down was excrutiatingly uncomfortable, so I alternated between pacing my 4 steps and sitting in a rocking chair for hours at a time.
S fell asleep around this time, and I was sitting alone in the labor room trying to breathe through contractions that were coming immediately on top of each other with no relief. By 1:15am, I was at the end of my rope from the pain. I called the nurse and told her that I needed the narcotic, which was administered at 1:30. It was supposed to last an hour, but I only got 45 minutes of partial relief. At 2:30am on the dot, I asked for a second dose. This one was even less effective, providing very limited relief and wearing off entirely by 3:00am.
S had woken up by this time, but no longer had any idea how to help. My pain for the last several hours had been a 10 on the 1-10 pain scale, and I was reaching the point where I didn't think I'd be able to cope. The nurse told me that I was allowed only one more dose of the narcotic, but she wanted to check my cervix again before giving it to me, since it hadn't been checked in the past 5 hours. She checked at 3:30, and low and behold, I had progressed to 3cm. Adding only 2cm during 5 hours of excruciating pain was discouraging, but it also had brought me to the point of "qualifying" for an epidural, so all wasn't lost. The nurse asked if I wanted an epidural now, and I gasped "Yes, yes yes!" over and over. The anesthesiologist arrived quickly, and the nurse went off to get a last narcotic dose to help me to stay still while the epidural was put in. (This was actually the most annoying part -- the nurse got locked out of the computer while trying to get the narcotic, which left me and S alone with an extremely shy anesthesiologist for what seemed like ages, with him holding the epidural drugs I was so desperately waiting for while he mumbled apologies that he couldn't give them to me yet.) Once he was able to start, however, the administration of the epidural was actually MUCH easier than I expected, and I was gratefully feeling the pain lessen dramatically by 4:30am.
The pain had largely returned by 7:30. The nurse determined that I probably needed a boost to my epidural, but first decided to check my cervix one more time. I had progressed a bit more, to somewhere in the 4-5 cm range, but more importantly, my water broke as she was checking, which promised to bring along faster progress. An internal monitor was placed on the baby's head (a big relief to me, since I meant one fewer strap around my belly -- those straps had been on continuously since the previous afternoon, and I hated them with a passion). Then, I was okay'ed for the epidural boost, this time from a different anesthesiologist. This event turned into the most surreal part of the delivery.... I THINK that the anesthesiologist was simply trying to confirm that the extra medication was working by asking me questions and judging how coherent my answers were. At least, I like to think that's what he was doing. I'm pretty sure that's how he started anyway. He asked where I worked. He asked what kind of work I do. I answered each question, and eventually assured him directly that I was feeling much better, the medication was working, everything seemed much better. But, rather than leave, he told me that he was fascinated by artificial intelligence, and started asking me in-depth questions about my research. Um... okay. I'd been having non-stop, no-break contractions for more than 12 hours at this point, and as much as I love my research, this wasn't really the time or place to be discussing it. When he switched from mild interest to actually challenging the research itself (my "favorite" of his questions: "But how would you know if it were really intelligent?") I was done playing along. I gave some sort of clipped answer in my best leave-me-alone-already voice, then turned to S and pretended the anesthesiologist no longer existed. I'm still shaking my head that the conversation ever happened. I really did not expect to be doing a thesis defense dry-run while in labor....
The next 4 hours are kind of a blur, but by 11:30am, it was time to check my cervix again. Yet another nursing shift change had happened, and I no longer believed that it was possible for me to have progressed more than a centimeter or two. To my surprise, the new nurse announced that there was no cervix left at all -- fully dilated and effaced. Finally! He called the doctor to check me to be sure that things were looking good (both me and my non-reactive baby), but told me to wait to start pushing until the baby dropped a bit more, because he was still quite high in my pelvis. We sat in that holding pattern for more than an hour. The baby was still having periods of non-reactivity, but overall looked good. He still hadn't dropped, but since he seemed to be holding up okay, they decided to have me start pushing, even though I'd be pushing him a very long way. Starting to push was fine with me -- after sitting around being fairly passive for so long, I was anxious to take a more active role.
The nurse was able to verify that I was pushing effectively and fairly strongly, especially given the epidural, which was still partially numbing my lower half. After 45 minutes of pushing, he checked to see how much the baby had advanced. He felt around for a while, then felt around some more, then frowned and checked even more. Eventually he came around to the side of the bed and explained the situation. He had felt all the way around the baby's head, which was firmly lodged in my pelvic opening. Normally at that stage, they feel around the head to see how many finger-widths they could fit between the head and the pelvic bone, to get a sense of whether the baby will need to turn at all to fit through. In my case, the baby's head was firmly against the bone all the way around, making direct contact around the entire circumference. And this was NOT the widest part of the head.
I remember trying to process this information, asking the nurse what that would ultimately mean. The answer: the baby was not coming out this way -- I would need a C-section. S and I looked at each other, and I could see concern and fear in his eyes. We asked a lot of questions, but it mainly came down to this: I could keep pushing if I wanted to, and it was theoretically possible that the head would deform enough to fit through, but the odds of it working out were very slim. (We were asking so many questions that, at one point, he looked at us and said, "Look -- this is a fairly common procedure, but you do need to understand that it is major abdominal surgery. It's not something simple like knee surgery." S and I looked at each other and burst out laughing, which confused the nurse until we explained that S had knee surgery less than a year ago, and the recovery sucked, and he's still not 100%. As I've been recovering these last few weeks, our constant refrain is, "Take it easy and give it time -- it's not something simple like knee surgery!") Anyway, at that point the nurse left us alone to talk while he went to get the doctor to verify his conclusion.
When the doctor checked, and confirmed the cephalopelvic disproportion (CPD -- a fancy way of saying "big head, small pelvis"), we asked her the same questions, and essentially got the same answers. I could keep pushing if I wanted, but it would probably not help. But there was one thing that I just couldn't get past: I wasn't exhausted yet. I was a little tired, but I had gotten quite the hormone-induced energy surge when I started pushing, and I hadn't used up all that adrenalin yet. If I gave in to a C-section (and yes, it really felt like it would be giving in) before I was truly exhausted, I was afraid that I would always feel like I gave up. I told the doctor that I was feeling pretty good, and we wanted to keep trying, for another hour or so. Her response: "Okay, we'll let you give it the ole 'college try,' but we'll need to recheck you at the two hour mark." So, I kept pushing.
When we reached the point of 2+ hours, the nurse checked again. The baby hadn't moved at all -- his head was still firmly lodged in exactly the same place. The only change was that the baby's head was starting to swell "alarmingly" (his word) from the unrelieved pressure, and he was showing more and more signs of distress on the monitor. I still had some energy to spare, but the stress on the baby clearly outweighed my desire to deliver how I wanted. I squeezed S's hand, and agreed to go ahead with the C-section.
After that, things moved very quickly. Forms were signed, belongings were moved to a recovery room, S changed into scrubs, and I was wheeled down the hallway to the obstetrics operating room. I was introduced to my third anesthesiologist, who went along with my request to keep up a running commentary on what the heck was going on behind that annoying blue screen. After just a few minutes, I was told that I would feel pressure, like someone was sitting on my abdomen. That pressure was quickly followed by several baby cries, the best sound in the world -- the arrival (finally!) of our LL. He was quickly rushed off to the nursery, with S in hot pursuit, leaving me in the operating room to listen to my (female) surgeon and (female) anesthesiologist discuss how awesome it was that they had such great families and careers because they both have stay-at-home husbands. (Told ya I lived in a liberal, progressive area!) As they were finishing up, I asked how big the baby was. The surgeon's response: "They weigh him in the nursery, not here, so I don't know. But I'll tell you this: he sure wasn't small!"
Not small, indeed.
Coming up next: my attempt to get my posts caught up to the present day. Annoying confusion in the hospital; at home with 8 million out-of-town family members; the picture-perfect no-tears bris; settling in, complete with grandparent slave labor; and finally, the three of us alone as a family.
Wednesday, September 24, 2008
He's Here!
Our son, LL*, was born Friday, September 19, at 3:00pm. He weighed a ridiculous 8 lbs 13 oz, he's 21" long, and he has a surprisingly gigantic head. (Thanks for that one, kid.) He's healthy, and extremely cute, so all is well.
Full birth story (or maybe partially full... I'm not sure yet) coming soon. A few "highlights" in the mean time: 23 hours of labor, an extremely surreal conversation with the anesthesiologist around hour 15, 2+ hours of pushing, disturbing signs of fetal distress, unmistakable cephalopelvic disproportion (CPD) that even had the hippy-dippy nurse-midwife apologizing, and ultimately a C-section.
We're home now, totally exhausted, dealing with the painful physical aftermath of both a long difficult labor and a C-section (me) and some jaundice and feeding issues (LL). At the same time, we couldn't be happier. More well-rested, yes, but not happier.
* Sorry, but I've decided not to actually include his name on the blog. Oddly enough, I don't want to type it here, but I'm okay dropping enough obvious hints that you can figure it out if you want to. It starts with an L, has only 4 letters, and is also the first name of the guy who invented blue jeans in San Francisco in the 1850s to sell to gold miners. Er... we didn't name him for the blue jeans guy, he's just the most famous person I can think of who shares the name, which is a good Hebrew name from the Torah. On the blog, I'll call him LL for "Little L___".
Full birth story (or maybe partially full... I'm not sure yet) coming soon. A few "highlights" in the mean time: 23 hours of labor, an extremely surreal conversation with the anesthesiologist around hour 15, 2+ hours of pushing, disturbing signs of fetal distress, unmistakable cephalopelvic disproportion (CPD) that even had the hippy-dippy nurse-midwife apologizing, and ultimately a C-section.
We're home now, totally exhausted, dealing with the painful physical aftermath of both a long difficult labor and a C-section (me) and some jaundice and feeding issues (LL). At the same time, we couldn't be happier. More well-rested, yes, but not happier.
* Sorry, but I've decided not to actually include his name on the blog. Oddly enough, I don't want to type it here, but I'm okay dropping enough obvious hints that you can figure it out if you want to. It starts with an L, has only 4 letters, and is also the first name of the guy who invented blue jeans in San Francisco in the 1850s to sell to gold miners. Er... we didn't name him for the blue jeans guy, he's just the most famous person I can think of who shares the name, which is a good Hebrew name from the Torah. On the blog, I'll call him LL for "Little L___".
Subscribe to:
Posts (Atom)
