Tuesday, June 16, 2009

Birth Story

Here's the long and detailed birth story. Enjoy.

Birth Story of D
May 28, 2009
7lbs 3oz.
20.5 in.

J: On May 26, we were 41 weeks pregnant. We had a midwife appointment at 8:15am to monitor D’s progress. This was the Tuesday following Memorial Day and we both really did not want to have to return to work after the long weekend. On the way to the appointment, I admitted my secret daydream that we would arrive to the appointment and they would say “This is it, you’re having this baby today. Head to the hospital.”

At the appointment, a vaginal exam found that I was 50% effaced and not dilated at all. The midwife C set up the Non-stress test to monitor the baby. One monitor measured contractions while the other measured the baby’s heartbeat. After 20 minutes of monitoring, C saw that the heart rate was decreasing at the start of every contraction. This was concerning, so she told us to head to the hospital for more monitoring. She said there was a 50-50 chance for inducing the baby that day. We were very excited and hopeful in the car.

Midwife S met us at the hospital, where we did another Non-stress test, this time for about 2 hours, and also a biophysical profile (an ultrasound). The Non-stress test found similar results and the biophysical profile found that the amniotic fluid was low. Both of these together concerned S enough that she thought we should go ahead and induce. She said “You’re going to have a baby!” and gave me a big hug. S is kind of sweet and grandmotherly and has the most experience out of the three midwives (25+ years). Then we checked into the hospital for the night.

Hospitals are a little weird about food and labor. Because there was a possibility for induction that day, the nurses would not allow me to eat any food. I ate breakfast before the midwife appointment and did not eat for the rest of the day. I kept asking for lunch at the hospital and the nurses would say “let’s wait for the results of your tests.” I was starving! When S said they were going to induce, I asked “Can I eat something?” S said “Yes, you need to eat. But don’t let the nurses see you.” Then she told K to sneak out and buy me some food and sneak it in. Thank god for midwives! K brought a Burrito Bowl from Chipotle and I scarfed it down in minutes, shoving it in before the nurses saw. Later that night S and C directed the hospital staff to allow me to eat and I was served dinner and breakfast the next day.

We started slow with the induction. Because I was not dilated, Cervadal was applied to my cervix at 5pm to work on starting dilation over night. The drug lasts for 12 hours. I was hooked up to fetal monitoring and ordered to lay on my side to measure the heartbeat for the rest of the night. I was given Ambian to sleep about 10pm because the midwife wanted to be sure I was well rested as tomorrow would be an exhausting day. Ambian was a first for me and I didn’t react well to it. I took the meds and then went into the bathroom to brush my teeth and get ready for bed, but while standing in there, I got hit by a sudden wave of exhaustion and emotions. I said “I think I need to lie down right now.” Then I got into bed and starting sobbing. K asked why and I sobbed “I don’t know!” I felt like I was on a boat in constant motion.

K: The nurses came in and acknowledged that what J was feeling was definitely normal for Ambian. One nurse did say that given her height and weight, she probably should have been given a lower dose, but it was within range. After about a hour J did finally fall asleep, but she woke up during the night off and on. She got sleep, but it certainly wasn’t as restful as it could have been. I slept on a bench in the labor room. Because J was constantly being monitored, occasionally an alarm would sound that we figured meant something was abnormal about either the baby’s heartbeat or the contraction. The really annoying thing is that the alarm would go off forever unless you call the nurse to turn if off. After number 3 I got so annoyed I yelled into the intercom something not so nice. Before all this, J spoke to midwife C on the phone. That night was her rounds at the hospital and she called J to check in. What really amazed me was that C volunteered to come to the hospital and just stay with J overnight as the Cervadal worked, even though there was no reason as all J had to do was sleep and wait for the drugs to work. That was really sweet and nice reminder of why we went with midwives. J told her to get her sleep and that we’d see her in the morning.

J: We were awakened by the midwife C around 5am. The nurse on call had called her in because of some irregular heartbeats she noticed from all that constant monitoring. C said we should shower and eat breakfast because we had a big day ahead of us. L, our best friend and Godfather of our soon-to-be-born baby, arrived around 7am. He just moved to the area and he couldn‘t have come at a better time. He was on call to help us through labor.

The Cervadal had dilated me to 1cm so we had a lot of work to do to get this done.

K: J was pretty disappointed that after 12 hours of Cervadal she was only 1 cm. I wasn’t too disappointed, because labor doesn’t just happen the first time around. Things take time. So my job was to be positive about that 1 cm and get the momentum going about the day ahead of us. Sadly, because we had to do constant monitoring J (and me too!) couldn’t use the nice massage hot tubs!

J: I put on my pretty purple labor gown that K had given me and was ready for a big day. We were all kind of anxious because we didn’t know what to expect.

K: I bought J a Pretty Pushers Dressed Up Delivery gift set that included a designer hospital gown, a matching headband, some lip gloss, lemon moist-towelettes and massage oil. I highly recommend getting this as a gift for the pregnant woman in your life! J looked so pretty.

J: Pitocin was started around 9am. The goal was to dial it up to contractions every 2-3 minutes. No pain medication, so this was an ambitious goal for early labor, but we were afraid to slow things down with an epidural and the strong fast contractions were necessary to make the dilation happen. At first they were easy to handle and we even played a game of skip-bo. But by the end of the game, things started heating up.

K: Things were looking so relaxed in early labor that I asked L to take over while I went to the waiting room to make some phone calls. I took my time and made my way back through the secured labor and delivery doors when I saw L briskly walking toward me. He said that J was crying and that labor was getting harder. She wanted me to get back now.

J: Labor was hard. K and L helped me through strong, hard, and fast contractions for many hours. It was rough. I alternated between walking and hanging on them, squatting on the birth ball, and sitting upright on the bed when I needed rest. Because I was on constant monitoring, many of the labor techniques I had learned didn’t apply, and we couldn’t use the hot tubs that we were so excited about. We were really limited in pain management techniques, but kept trying anyway. C sat with me through most of it, rubbing my back, rubbing my feet. This is where we knew using the midwives was the best decision. Who else would sit with us through every bit of this? We never felt alone in this.

K: When things started getting hard I found myself overwhelmed by just how painful this was for J. I’ve always said that the hardest thing for me in all this would be to see the love my life in such terrible pain and that was certainly the case. I had to do some yoga breathing of my own to keep from tearing up at the sight of her struggling to keep up with her contractions. I would be helping her with positions and luckily she never looked at my face because I was so sad for those first 10 contractions. After that I think I started to get used to the pattern and the sadness started to subside. On a more humorous note, J got to a point where she banned talking during contractions. This was something that we took seriously at the time, but it’s given us a good laugh since! We used to joke that I would be the kind of woman to tell people to shut up during contractions (if I ever were pregnant and in labor), so it was funny to find that in the moment J was that kind of woman too!

J: Progress was slow and by 6pm we had only dilated to 2cm. C later said it was like active labor during early labor because of the pitocin. Because progress was so slow and labor was so hard, I grew increasingly frustrated. Every exam made me more disappointed and disheartened.

C was off duty at 7pm and returning the next night at 7pm. She said that she thought she might see this baby born the next night when she was here - that the baby wouldn’t be born for more than 24 hours. This added to my frustration. I couldn’t imagine doing this pitocin induced labor for another 24 hours. This along with my slow progress really started to bring my spirits down.

K: Now it was getting harder to be positive with J. She was spiraling and getting more and more disheartened and that was hard to deal with. All the positive talk and calming tones don’t work so well at this point. Every positive thing I had to say, she had something negative back at me.

J: Luckily the baby was handling the labor very well and not showing any other signs of heartbeat problems. The midwife said we needed to make things happen faster, so she wanted to break the bag of waters to get the contractions stronger. I was starting to freak out a little at this point. I said “I know what you are saying is right, but I can’t agree to making these contractions stronger. I’m too exhausted as it is.” But K said “We have no choice, we can’t keep doing this forever.” So we agreed and broke the water. There was meconium in the water, another indicator that the baby was stressed, but C thought the meconium looked old, like it was an indicator of past stress so she wasn’t too concerned but wanted to watch it.

The contractions came strong and fast at this point and I started to really freak out. I asked for some kind of pain medicine. C said “you weren’t planning on an epidural originally, were you?” Almost yelling, I said “I wasn’t planning on having a pitocin induced labor!”

K: To clarify, we weren’t really planning on anything. Of course labor without any drugs is the best for your baby, but it’s not necessarily prudent. We never came to this point thinking that we would or would not do anything--like some women automatically say they’re getting an epidural before going into labor and some women say the opposite. We did neither, but had our preference of doing what is best for the baby. To the midwife’s credit, she carefully reviewed our birth plan and wanted very much to abide by it and I really appreciate that. Of course, birth is flexible by nature and plans change, but the fact that she knew our preferences and wanted very much to honor that is something we appreciate.

J: The two options were an epidural, where I would feel nothing but the labor would be slowed down, or Nubain, which is a narcotic that takes the edge off but still allows for labor to progress. C said Nubain was better for early labor. This was discussed for what seemed like a really long time for me and I wasn‘t feeling mentally able to make any kinds of decisions. I felt like there was all of this talking and talking and in the mean time I kept having more and more contractions. Finally I said “I don’t know what to do, but we need to make a decision fast.” K said quickly “Let’s try the Nubain.”

K: I would have made the decision earlier for J, but I didn’t want to tell her what to do. My preference was to use neither, but if J wanted it I would have done Nubain first to see if that worked. I didn’t say anything, just waited for J to ask me what she should do and when she finally did we went with Nubian.

J: The Nubain worked okay. I was able to manage the contractions for a while. But the Nubain only lasts for an hour and when the contractions came back, they came back strong, stronger than before. At this point, I was practically begging for an epidural. It was time for a shift change for the midwives and S came back. As soon as she came in, C said to S, “She’s asking for an epidural.” S got things moving and the anesthesiologist came fairly quickly. At this point I was only 3 cm.

K: This was an interesting point for me. Because I really thought that J was not going to get an epidural. I’m not against an epidural and to the contrary we’ve joked that if I was the one who was pregnant that I’d probably just schedule a c-section (not really a joke, I would totally do that). So the fact that she was so intent on getting an epidural made me realize that she really needed it, because she would not have asked for it if she didn’t. We were still in early labor and her contractions were coming every 2-3 minutes, more intense than if the contractions had ramped up naturally. Actually, after reviewing some info on contractions post-labor, we found that when your contractions are 2-3 minutes apart that’s more like the transition phase of labor which is right before you should be birthing the baby, but of course we were still technically in early labor (where contractions should be much less challenging).

J: As C was leaving, she said “If this baby is born by midnight, it will be a girl. If it’s born by 7am, it’s a boy.” We’d been hearing a lot of these predictions so we just laughed this one off. S said many times throughout the night that she was convinced it was a girl. We’d spent most of our appointments with her and she was there for my gallstones emergency at the hospital, so she’d certainly spent enough time with us to get an idea.

I was pretty much gone at this point, barely able to handle each contraction, and I was really freaking out. The anesthesiologist came in jovial and telling jokes. I was practically yelling at him. L had to go in the hall during the procedure and he could hear me yelling out in the hall. The anesthesiologist made me change into a real hospital gown instead of my pretty purple dress--asshole.

The epidural was amazing. I didn’t feel any of the contractions from this point on. I went straight to sleep and K and L ate dinner and everyone relaxed a little bit. I could hear them talking and laughing but couldn’t focus on what they were saying because I was so exhausted. My legs were completely numb. I kept thinking that I should tell someone that my legs were numb, like that was something to be concerned with, but then I would remember that my legs were supposed to be numb. We were able to sleep/rest for a few hours.

K: The epidural was amazing -- we went from frantic and dazed to peaceful and calm. While J, of course, took the brunt of all this, L and I were exhausted as well. My back was aching from all the weight J put on me during the contractions. She would use me to sway back and forth, she would rest on my shoulders, lean on the back and front. Basically many of the labor positions we tried, and as her wife I wanted to be part of them all (not just asking L to always take over). But after so many hours my body was aching too and I was happy for the respite.

J: S monitored the baby as the contractions got stronger and saw the problems with the heart rate coming back. She placed an internal monitor to the baby’s head for a better read and got similar results. She came in and said she thought it was time to call it and do a c-section. This was around 10:30pm. When she said it, I was relieved. I thought, finally, this will be over. The doctor was called in from home and we prepared for the c-section. At this point I was only 4 cm dilated and 80% effaced.

K: I was so happy that we were doing an c-section. I felt bad for being happy about it, since this is major surgery but I was relieved. I was happy that our baby was finally going to be on the outside and it didn’t matter to me (it never did) how she got there. I was worried that recovery of the c-section would be hard, but that was a thought for later. Our baby was soon to be born!

J: K put on scrubs. The doctor came in and introduced himself, wearing his casual clothes. All of this is kind of vague to me. I was basically exhausted and relieved and didn’t care much more about what happened next as long as the baby was safe. The anesthesiologist came back in to expand my epidural. The normal labor epidural makes you numb from the waist down, the c-section epidural makes you numb from the shoulders down.

My bed was wheeled into the operating room. K had to wait in the recovery room until right before the procedure. The room was super bright and cold and there were a lot of people in there, none of them introduced themselves to me. The doctor was there, and S was there. She seemed to be there to interpret things for me - everything that was done to me she would explain to me what was happening and why. They tied me to the metal table. A man was soft and gentle, but I don’t know what his role was. A curtain was hung directly in front of my face. K was brought in and sat on a stool next to my head.

The operation was strange. I was awake but completely numb. It felt like at the dentist when you feel what’s happening but feel no pain. There was a lot of pressure. The weirdest part was when they pushed the baby out. The incision is a small hole just below my belly, just big enough for a baby to fit through. The baby is pushed through the hole and you can feel the pushing. I thought I was going to puke, but didn’t of course.

Then at some point I heard a baby cry. I asked “Is that our baby?” The anesthesiologist yelled “It’s a baby girl!” K asked“What time was she born?“ People in the room asked around - what time, what time? Someone said “12:09”. K was allowed to go see the baby as she was examined and cleaned up. She was allowed to hold the baby and she brought her over to me. I was still being stitched up and was still tied to the operating table. I wanted to see the baby but was also very uncomfortable. I felt very guilty - I knew I should want to see the baby but I was so uncomfortable. S said she knew it was going to be a girl.

K: I brought the baby over to J and put her just within reach so J could stroke her face while still tied to the operating table. She seemed happy to have that moment, but also deep in concentration as she was still in surgery. So D and I just sat there offering our support to Mommy.

J: I was transferred onto another table then wheeled into the recovery room. D was put in between my legs and traveled with us. I started shivering uncontrollably. S said I should breastfeed. I was shivering too much to feel comfortable holding my baby. I said that I couldn’t. S said that I didn’t need to do anything, just stay still and let her have my breast. She placed the baby to the breast and got her to feed while I dozed on and off and shivered.

K: Our original birth plan included the baby being put to J’s breast directly after birth. Of course with a c-section that wasn’t possible, but D was put on J’s breast as soon as possible (probably a half hour later).

J: The nurse gave me Demoral for the shivering. I kept shivering and asked S if the nurse really gave me Demoral because I wasn’t feeling any different. S assured me that the medicine was given. Then I asked if they removed my placenta during the c-section. I was afraid I would have to birth that, but S assured me that it was removed as well.

S told me that she was happy I had an epidural. She said she didn’t think there was any way this baby was going to come out naturally. She thought I was trying to push a square peg through a round hole - that the baby was just too big for me. She had actually told me this at my very first vaginal exam - that she was concerned my pelvis was too small. With 25+ years of experience, she probably knows what she’s talking about.

K: In retrospect, this may have been partly our fault (though haven’t talked to the midwives about it). We chose a donor who is the average height for a man (5’10”) and who has parents and grandparents who are even taller. D was born at 20.5 inches. Maybe our donor is a little too big for J’s body. Unfortunately, South Asian men are hard to come by in terms of sperm donors so our pool was slim.

J: S gave me a hug and a kiss and left for the night, as soon as D was cleared and I was ready to transfer to postpartum.

The nurses took the baby for a bath and took me to the postpartum room.

K: I was asked if I wanted to go with the baby and oversee (I guess) her bath. I felt absolutely no guilt at saying no. I wanted to stay with J and make sure that she was okay first and I would do the same thing over again.

J: It was about 2:30 am. K went to find L who had spent this time packing up our stuff (we moved in, practically) and I said “Find our baby! I haven’t held her yet.” L and K came back to the room and I said “Where’s the baby? I haven’t held her yet!” K said they had her in the warmer and they’d bring her in when she was warmer. A nurse came in and I told her I wanted to see my baby. She said the same thing K said. I was feeling frantic because it had been a few hours and I hadn’t held my baby yet. When she was first born, I didn’t want to hold her because I was so uncomfortable, but now I couldn’t think of anything else. Finally the nurse brought her into the room in a bassinet and I said “Let me have her!” K handed her to me and I held my baby for the first time and it was amazing.

K: Right after D’s birth I was on a deadline. I had 2 hours from birth to call the cord blood bank courier about packaging and picking up D’s cord blood to have it air mailed to California where it will be stored. Because this was so important and because we had to get it right, that’s all I could think about. Until L and I got that package placed in the courier’s hand, I was preoccupied. I know J was anxious about D, but I couldn’t concentrate on her.

J: L slept in the fold out sofa and K slept in the recliner. The bassinet was placed next to my bed and neither K nor I slept that night. Every time she made a noise, I told K to get up and investigate. I couldn’t walk (I couldn’t even feel my legs) or I probably would have stood next to that crib the entire night.
We really appreciated how well the midwives wanted to stick our birth plan. After S said we needed to do an emergency c-section all our other preferences went out the door. However, she still strived to meet our preferences even in our changed situation. For example, K got to be in the operating room right beside J. As soon as the baby was born our original preference was for K to “catch” the baby as it came out. As soon as the doctor got the baby out of J’s belly, D was carried over to the warmer and S led K directly over right away to see our baby. K couldn’t touch until the pediatrician and nurses were done cleaning her (they called in a special Neonatologist), but as soon as they were done K got to hold her baby first as planned. (The baby’s Apgar score was a 9--so actually very healthy.) Then K brought D up to J while the operation was still going on and J could touch her and see her beautiful face. The original plan was after catching the baby, the baby would be placed on J’s chest for breastfeeding right away. Given we had a c-section we couldn’t do that. However, as soon as the operation was done (as it’s a quick procedure) the baby joined us on J’s bed and we were taken to a recovery room where S helped D to breastfeed from J. J was out of it and shaking uncontrollably (happens to vaginal births too, related to hormones) but S wanted us to have that experience and more importantly to start off as best we could with breastfeeding with D. While things didn’t go as planned, our preferences (before, during and after the c-section) were respected and that made all the difference in terms of our how we view this experience.

We really trust the midwives and that made this whole process so easy for us. In our childbirth class all the partners kept talking about their roles being to be really informed and having to constantly fight for a vaginal birth (as opposed to just automatically going for a c-section). Since we really trusted the midwives, we never felt like we had to fight for anything or even had to be that knowledgeable of the process ahead of time. They always explained everything really well, always let us ask tons of questions and were really supportive through everything. We knew that when S said we needed a c-section, we needed a c-section. There was no question. Having talked to other women due around the same time as us, they were being pressured into c-sections and really had to fight to wait it out. One even said they found out that (after the fact) her doctor always had a birth on his birthday, and so she was induced! We surrounded ourselves with professionals we trusted and just let go. We will definitely use the midwives again, though likely to co-manage another c-section.

We are in love with Shady Grove Hospital. Everything was so nice. We live 2 miles away from our local hospital, but it was totally worth the extra miles to give birth at Shady Grove. Everything was new, all the nurses and staff were excellent. They all treated us so well. There was Mom (J) and the other Mom (K). Many would refer to us as the mommies, etc. We felt really welcomed there and that’s an important thing to feel during such a huge life event.

The Birth Partner by Patty Simkin was an excellent book and I highly recommend it for partners. It really helped me be useful for J--to help guide her through contractions, help her find the right positions and help her focus on her breathing and remaining calm. Of course, with a c-section I didn’t have to do anything but through the 14 hours of labor I was happy I had the knowledge from that book. In particular, I’ve never thought of childbirth for myself and always (even very young) assumed I would just adopt. As a same-sex couple we then had 2 uteruses; J really wanted to be pregnant and I really wanted an Indian baby so I found myself having to go through conception, pregnancy and childbirth after all. I couldn’t have done the latter and most challenging part without this book, it really helped me through something I never wanted to experience in the first place.

With that said, pregnancy and childbirth is fine but having the baby is the best part. Some women feel really tied to the experience of childbirth. So many women who have told us their birth stories would recount all the bad things that happened and how they hated this or hated that about their experience. I don't think we hated anything about our experience because the point of all this is to have the baby. We got pregnant in the first place because we wanted a baby--not to share in some sacred experience of women all over the world. Having that viewpoint made it easy for us to let go and just let things happen during birth. So in that respect, we had a wonderful birth experience and we're very blessed to have a healthy, beautiful baby.
And now with writing our birth story, we are happy to close this chapter of our lives. For 9 months we've been hearing nothing but birth stories from everyone, strangers alike, and by like month 4 we were totally over it. We're so happy to have pregnancy and birth behind us--now we're onto the fun part!

1 comment:

Anonymous said...

Thanks so much for sharing your story! You both went through so much, and it sounds like all the best decisions were made. What's fabulous is that you have little D to show for it all. Congratulations, moms!