Sunday, February 28, 2010

Labor Story: Lennox

Once again, I will give fair warning. If you have not had children, or are a little squeamish, you may want to skip this. Not that this was a bad delivery at all or anything. I just always hate when people push labor stories onto unsuspecting or unwilling listeners. So this is your chance to back out.

Warren's delivery played a significant role in how I prepared for Lennox's birth. For those who weren't around when Warren arrived you can read his delivery story here, or I'll just give a quick recap. Due to some decade-old medical issues, I had a significant amount of cervical scar tissue that would not allow for any dilation when I went into labor with Warren. This lead to a number of medical interventions that all combined to create a horrible delivery. Labor lasted more than 33 hours, involved Pitocin, the baby being horribly positioned (not even "sunny side up" sideways... meaning the biggest part of his head was trying to push out through the narrowest part of my pelvis) epidural, two-plus hours of pushing that resulted in getting Warren thoroughly stuck in my pelvis, and an emergency c-section. So, my worst possible delivery that still resulted in a healthy baby.

With this in my medical history, my chances of having a normal vaginal delivery were iffy. I really wanted to have a VBAC (vaginal birth after Cesarean), but was trying to temper my expectations and view it realistically. So, I did everything I could to prepare.

I spent a lot of time thinking about what I was most afraid of, and the answer was not a horrible delivery. It was that my body would fail me again. That was how Warren's birth left me feeling, that I was robbed of the birth experience, and that it negatively impacted bonding with Warren, made breastfeeding really hard and made for a horrifying recovery.

I read every book that mentioned VBAC delivery, and found that VBACs are least successful when there are medical interventions. And after Warren's delivery, I was well aware of how quickly one issue leads to a cascade of interventions. So, I committed to having a completely natural delivery.

I spoke to my doctor, I got a doula. The plan was this: go completely natural and avoid all unnecessary interventions. As soon as intervention became medically necessary, they would roll me to Operating room. If I didn't go into labor before my due date, they would schedule a c-section a few days later.

So, I felt a lot of pressure to get labor going before February 5th rolled around. But, I was still working, and had a couple of huge projects hanging over my head. I was thinking that I would work until the baby arrived. A few days before my due date, I made a decision, after my due date, I would not be coming in to work again. Baby or no, Friday the 5th would my last day on the job. My boss was terrified that I wouldn't get my work done and he'd be left holding the bag.
On the 5th, lucky for me, a 13 hour work day allowed me to finish both projects, just in time for my last prenatal appointment.

Xtian joined me at the doctor's office, where we hoped for good news, and knew we'd be scheduling the c-section. Knowing how dilation went last time, I was hoping for a decent amount of dilation, or at least some decent cervical "ripening." I love this doctor, she was so supportive of the VBAC plan, and was really awesome in helping me feel good about that decision. So the doctor came in, checked me and shouted "AWESOME! 3 centimeters!" Keep in mind, no matter if you are in labor or not, hospitals admit you at 4 centimeters. So, being dilated to 3 was fantastic news.

Just in case, we scheduled the c-section for the following Thursday. Though my doctor told me she had no doubt I'd go into labor before that.

So, feeling awesome I went grocery shopping, stocked the fridge, and went to bed. We spent Saturday running some errands, baking bread, making my first mozzarella cheese, and kind of getting the house in order. Then I poured several drinks into Xtian to help with labor induction (FYI, not to get into overshare territory, but sex can get labor started. So... yeah).

I woke up Sunday at 4 am, with aching hips and feeling uncomfortable. So I went downstairs to try to sleep in my recliner for a few more hours. Right as I dozed off, contractions started. Nothing bad, like bad cramps, no pattern to them at all. This was Sunday, February 7. Superbowl. I remember thinking "Oh great. Leave it to my kid to make me miss the Superbowl. What a jerk."

So, I got up, and started cleaning the kitchen and tidying up the house. Figuring this might a long day, I wanted to give Xtian a little more sleep. Finally about 6 am I was tired of doing this alone. So I went and woke Xtian. While he went to shower and shave, I sent out the text to the family. "Call when you get this... Showtime." I called the doula to let her know that labor had started, but the contractions weren't organized, so we had a while yet. I told her I'd call her when things got a little more intense.

Xtian and I went downstairs, ate a little breakfast, and finished packing the hospital bag. By this time Warren was awake, so we brought him downstairs and woke up Cory. All this time, I was fine between contractions, and could get through contractions with some breathing, moaning and laying on the birthing ball. At first Warren was having fun yelling along with me. At this point, my plan was to stay at home as long as possible. The thought being, the less time spent in the hospital, the less chance for the doctors to push interventions on me.

By about 8:30, contractions were about every 4 minutes, lasting about a minute each. I was still dealing with the pain just fine. When Warren started to get scared by the sounds I was making, I realized that I needed to go to the hospital now, or I might not be able to physically sit in the car. So, we called the hospital, told them we were on the way, called the fam, and the doula, told them to meet us there. We left Warren in Cory's capable hands, gave them both a kiss, and got on the road.

General labor wisdom holds that labor slows down on the trip to the hospital. That was not the case for me. Every 3 minutes, nasty contractions had me hanging onto the hand grip like it would save my life. By 9 am we had arrived at the hospital, parked, and got all set up in triage. I still had my sense of humor, and felt good. They checked me out, watched the fetal monitor for a while and declared I was dilated to 6. Great, progress, still had a few hours to go. Kind of picture perfect scenario. We filled out some forms, including the VBAC waiver (since malpractice insurance makes you sign a waiver acknowledging that there are RISKS involved with a VBAC, even though there are fewer risks in a vaginal delivery than there are in a second c-section. Screwed up? Yes it is. Our medical care is determined by lawyers and accountants, it is complete bullshit).

At 9:35 am we grabbed my stuff, and walked to my delivery room. Had one contraction on the way, still doing fine moaning and swaying through it. As they got the room set up for me, I stopped in to use the bathroom, and as soon as I came out, labor changed.

Suddenly, it was all I could do to hold on to my birth ball and scream through each contraction. My doula and Xtian were coordinating some massage and counterpressure on my back that was helping significantly. That was their job. I think I told them I would die if they stopped.

Since I was Group B Strep positive (a harmless bacteria that lives in about 70% of people, but can be dangerous for the baby), I was supposed to be given antibiotics during labor. So, the nurses were trying to get an IV started. Of course this is nearly impossible when a woman is in labor. And I have always had tricky veins. Even the best medical professionals have a hard time sticking me. Let alone when every other minute, I'm gripped with incredible pain and can't stop shaking in between each contraction. While the nurse was trying to get an IV started, my parents arrived and jumped into action holding my hands and trying to help me hold still to get the IV going. Three sticks and a dozen contractions later, they finally got a line going, but I was pouring down sweat so they couldn't secure it.

My brother and his girlfriend Merrilee arrived about this time. (Side note: Merrilee has not spent much time around kids, and is a little terrified of the whole pregnancy/baby thing. So, god bless that poor girl for being there.) I was still with it enough to realize that they were going to be terrified. Before the next contraction started, I warned them both that I was loud as hell, but it was ok.

All at once, I realized that I could not really stand up anymore. So I declared that I needed to get up on the bed. I only had a few seconds before the next contraction started. I was lying on my side, holding the bed railing for dear life. Around this time, the doctor came in to check in. She took one look at me, heard one contraction and said, "I think we need to check you again." It was about 10:30 am, and I was 10 centimeters, but she said a little "lip" had formed. She asked me to roll on to my other side to reduce the lip. I told her she was out of her mind. It took everything I had to roll over, but I managed to do it with some help from... well everyone.

After two more contractions, I had to get up. I physically needed to get on all fours. I cannot even begin to describe the primal need to move to another position. All around me, I was vaguely aware of the doctors and nurses moving around at a frantic speed. This kid was coming, and they were in no way ready.

All at once, I realized I was pushing. And oh my god, the pushing felt so much better. The doctors were telling me to hold on, they were almost ready. At this point, I wasn't listening to anything but my own body, so I completely ignored them. I was pushing, it was happening, they would need to work around me. I felt a little trickle of moisture, and realized that my water had broken. Even between contractions I was completely unable to make words or communicate. All I could do was lie still with my eyes closed and breathe.

I really didn't want to move into another position. But of course, I had a doctor attending my birth, not a midwife. I had asked for the midwife but since I went from "doing fine" to "pushing" in under an hour, the midwife didn't have time to get to my floor. The doctor was fine, and she tried really hard to respect my wishes, but she wasn't experienced enough to deliver the baby in any position other than lying down. I didn't have the ability to argue, the doula tried, but in the end, they had me in stirrups anyway.

So they made me reposition myself, which sucked, but I still managed to push in a more comfortable position, since they couldn't have stopped me from pulling myself off the end of the table so I could push from a squatting position, even while in the stirrups.

Here's where things got interesting. As soon as I started pushing, contractions stopped hurting. In fact, nothing hurt at all. The doctor and nurses were all instructing me on how to push. I wasn't listening to them, I was just breathing and pushing when I felt like it, and nothing hurt. My eyes were closed during all of this. I was just completely focused inward. As far as I knew, I may have been the only person in that room. Completely strange and surreal, considering there were about 15 people surrounding me at that moment.

I suddenly opened my eyes and was confronted with a pool of blood at my side. It scared the hell out of me, so I yelled, "UM! THAT'S A LOT OF BLOOD!" No, I wasn't hemorrhaging, I had ripped my IV line out of my arm and in all the action, no one was applying pressure. So with every contraction, as I used my arms to pull myself upright, blood was pouring out of my arm. This was enough to shake me out of my meditative state, which kind of sucked, in hindsight.

Now, I was aware of all the random people giving me directions. Each contraction, I had no fewer than 5 medical personnel telling me what I was supposed to be doing. They kept yelling things at me, and I remember feeling like I must be doing it wrong, so I kept apologizing. "I'm sorry! I'm trying!" After one good push, the doctor told me to reach down and feel the baby. I didn't want any part of that, since if I could actually feel the baby, shouldn't it just be OUT OF ME ALREADY?

But, at least this made me realize, that shit, I knew what I was doing. I was getting this done, even when I wasn't listening to all the directions. So, during the next contraction when everyone started yelling at me again, I just kept repeating, through gritted teeth, "Shut up, please. Shut up, please." And remarkably, everyone shut up. It was a godsend. The quiet!

After the next contraction, the doctor began to warn me about the "ring of fire." I've heard of this, and I was terrified. She warned me that when I started to feel it, I just needed to push through it. So, I took a deep breath, and pushed. "Here comes the ring of fire, so just keep pushing," she said. I breathed, I pushed, I never felt the pain. I got to miss out on the whole ring of fire experience. The urge to push continued for what felt like an hour, so I just kept breathing in, pushing, breathing in, pushing until I felt all the pressure release, and they put my baby on my belly.

A nurse shouted out, "11:01 am!" I reached down and held my baby and felt a flood of "Holy shit, I just pushed a baby out of my body!" I was vaguely aware of a flurry of activity, and at some point, Christian remembered to tell me it was a boy.

I know I'm forgetting a million things about the day and the birth, but that's the gist of it. In just about 6 hours of labor, no medication, and with only a handful of stitches required, our new baby boy was born in time for me to watch the kick off of the Superbowl. And isn't that the most important thing?


Carley, John, Cohen, kennedy said...

Wow.. that is awesome. I really kind of want to look into a VBAC, but every time I mention it I hear how dangerous it is.. but it sounds like you did well. CONGRATS! Kennedy was an emergency C, as she was breach.. but it sounds like your emergency c was bad, especially after hours of labor.. I'm glad this went more the way you wanted it.

Faith said...

I do NOT want to know what the ring of fire was referring to. Nuh-uh. ::shaking head vehemently::

I'm so happy for you guys! And good fucking job, sista. I'm proud of you for doing it the way you wanted to!

Coley said...

Carley, I was afraid of the "dangers" of VBAC too, until I did some independent research. turns out, repeated C-sections are far, far more dangerous to mother and child than VBAC. I highly, HIGHLY recommend the VBAC. So much easier than that c-Section.

Thanks Faith, yeah, I can't imagine what that ring of fire thing woudl have felt like, and I think I'm glad I don't know.

jen breese said...

WOOOT! Great story. And darling little boy to snuggle.