Jami Finally Writes Out Her Birth Story

This post isn't, necessarily, for you. It's for me and it's going to be long and probably some people's definition of graphic, or just plain TMI. But this is the birth story, start to finish. I need to get it down for my own sake, and I don't mind sharing. I've been writing little bits when I have a moment, which is why it's taken 3 weeks. Also, before parts that get too personal, I'll put a little *** - if you see that, you can decide if you want to skip the paragraph that follows the stars, which might be more than you want to know. Sort of a "read the following paragraph at your own risk." Or skip this whole thing, I won't mind, honest. I'm all about birthin', but it's not for everyone, believe me, I know. The last thing I'm going to say in this intro is that before I start, I want to acknowledge that the Husband totally kicked butt at this - if every husband could do what he did, you wouldn't need a doula. I wouldn't have gotten through the days and days without his unwavering, comforting, perfect support. Just saying. As you may have gathered, if you've been reading this blog regularly, this pregnancy didn't go quite as I'd envisioned. Pretty much from the first ambiguous home pregnancy test on, it seemed that each time I accepted the problem at hand, and got to a good place, the next shoe dropped. Probably not a great metaphor unless you're a centipede, because it was way more than 2 shoes. Ever the optimist, I got through each challenge thinking that this would be it, smooth sailing from here on out, and then I'd visualize my perfect birth situation. Because I just knew that it would be fine. I've read, learned, seen, experienced. I did all the exercises and knew all my options. I'm prepared, I thought, and that's the key. So, it came as a bit of a shock to me when last Thursday, Sept 17, my midwife told me that with my blood pressure still creeping up, my urine tests showing me close to pre-eclampsia and the extra challenges present by gestational diabetes, I should consider induction. I wanted to wait, to try to start labor naturally, but that close to the weekend, it was start it now or wait until the following week, presenting some very real health concerns. At the time, she said I was 1 cm dilated and 70 percent effaced, and that far effaced, I felt a little better going against the first thing on my birth vision: I want to go into labor on my own. Births don't always follow our desires, I know, but I've seen a nice birth that started with an induction, and I still felt confident that I would have a lovely birth. And so we went in. Right away the nurses put in an IV, against my wishes, and stuck me on the monitors, also against my wishes. When I questioned these actions, I was told it was standard and that's that. My midwife came in and fortunately was able to get them to cap off the IV with a heparin lock (so I wasn't attached to anything) and while they did find the telemetric monitors (sort of remote control so I wouldn't be stuck to the machine) they hadn't been charged, but since I was going to be sleeping soon anyway, I was able to compromise with great grace. The midwife showed me how to unplug it so I could use the restroom (to the nurse's initial distress, though after looking at both of us, she shrugged, "well, whatever"). Hey - it saved her a bunch of trips into my room. At 10 pm, I was started on Cervadil, which softens the cervix, preparing it for effacing and dilation. It's not usually something that starts "labor" as you think of it, so the plan at that time was, sleep while the drug works its magic, wake up and have the baby. But before that I had to talk to the doctors, since I had gestational diabetes. The doctors treating my gestational diabetes wanted to do an ultrasound, so they could scare me by telling me the baby was too big to be born vaginally. First the residents spent 45 minutes pressing the wand on my belly to the point where I expected to be bruised from it, only to get "inconclusive" readings since Griffin refused to stay still long enough to take even one accurate measurements. They left to find their attending, who spent another 30 minutes poking me with the same results and then explaining to me that since they couldn't get a measurement, they had to assume the baby was over 10 pounds and that would mean all sort of complications that could lead to a Cesarean section and I should start thinking about that. The midwife felt my belly with her hands and estimated around 8 pounds. Guess who was closer . . . My doula wouldn't be called until we hit some actual action, so the Husband and I sacked out and attempted to rest. Of course, because of my high blood pressure, they had to take it once an hour, and take a finger prick for my blood sugar every 2 hours. With that and adjusting the monitors every time I rolled over, it wasn't as restful as "sleep" usually is, but it was something. I woke up around 5am with the urge to walk around. I found a nurse to switch me to the telemetric monitors, put on my non-skid socks and my iPod and went trucking around the ward. Most rooms had been full and they were slowly emptying out. I heard various women's shouts and moans, following by baby cries. I walked faster, picturing the motion working the baby down. I ran through my vision of how the birth was going to go. It wouldn't be long now. At 7ish, a new midwife came on duty. She checked me again and found that I was still at 1 cm, and in her opinion, not even 50% effaced. Did I want to start pitocin to start contractions? Or another drug for softening the cervix? Neither appealed to me for various reasons I will be glad to discuss if you really want to know. I wanted to try walking some more and the midwife also suggested a foley balloon. So I ordered breakfast and had the balloon. That breakfast was the last solid food I was allowed to have and I enjoyed eggs, bacon, sausage, yogurt and tea from room service. Yummers. *** A foley balloon is basically a surgical tube that the midwife inserts into your cervix and blows up like a balloon. The pressure of the balloon can help your cervix open and then when it reaches the size of the balloon, the balloon falls out. This prompted me to call my friend Lexi and tell her that there must be a party going on because there's a balloon in my hooha. This procedure was about as comfortable as you're imagining it to be. I ended up crying to Lexi a little because things weren't going as I wanted, and her support really gave me a boost I sorely needed. The foley balloon and walking caused me some good cramping (good in the sense that I felt like something was finally happening). The nurses noted that of all the laboring moms they've seen, I held the landspeed record. One kept telling me "no running". The moving felt good, though, and I would chug it out for 25-30 minutes, then get some rest or bounce on the birth ball. About this time I learned that my doula, Jan, had a reaction to a medication she'd been given and was at home with a rash, fever and vomiting. I still had a back up, and there's nothing wrong with Teresa, my backup, but I'd planned on Jan. I wanted Jan, in my mind, it had always been Jan and this was one more thing going wrong. I started to feel crushed. I didn't want to be induced, I didn't want pitocin, I wanted Jan. Around 11am Friday, the balloon had accomplished its goal and the midwife checked again - sadly, was only at 3 cm and still not any more effaced. Time to start the pitocin, she suggested, or, start all over with the Cervadil. A weepy call to Teresa later, we decided on the pitocin and I got hooked up to the IV. We named the IV pole "Irv" (IV with and "r" in the middle") and after a brief nap, Irv and I did some more laps. The nurses chased me around to keep the baby on the monitor while I moved. Now that I'd been on the pitocin, they limited me to "clear foods" - broth, tea, clear sodas, Italian ice (the lemon and orange were particularly yummy) and Popsicles. Remember, this is noonish on Friday, and I didn't have the baby until Sunday morning. As tasty as brother and Italian ices are, it's not the kind of meal that you enjoy every few hours for two days. The pitocin began to be turned up regularly, and I walked, bounced, squatted, rested and repeated. I changed position every 1/2 hour at least, peed every hour the way a good doula should. We called family and friends regularly, FaceBooked and texted updates (which were mostly "nothing new here") and waited. I had some crampy feelings, nothing like the labor you see in movies where women are writhing and screaming. A new midwife came on duty, things seemed to maybe be moving. She checked me at about 11pm Friday night and it looked like finally, finally, I was set to go. I'd hit 5 cm dilated (usually considered the beginning of active labor) and though I didn't seem much more effaced, she felt that I was "softer" than before and that now things would really start jumping. We called Teresa who headed in. Generally, we tell women that getting to 5 cm is the longest part. Jan usually says that you are 75% there when you hit 5, not just halfway like it sounds. So I was set. I could feel it. They wouldn't turn the pitocin up anymore since it seemed to be working. I took a rest and then went back out walking, knowing that this was it. I had the iPod on, and Little Wonders (These Small Hours) came on. It was such a boost, my spirits soared - I sang along, really feeling the song "these small hours, these twists and turns" - yeah, I'd felt the twists and turns, and I'd dealt with them, and now, in these small hours of the night, I was getting ready to finally greet my son. Teresa arrived, and we spent some time getting her caught up. We rested as well as we could, thinking that very soon it'd be too hard for me to really rest. Friday melted into Saturday morning. Since I had now hit "active labor" (5 centimeters dilated), the doctors insisted I had to have my blood sugar checked every hour. That meant 36 more times I had to prick my fingers. Do the math - I don't have that many fingers. They were literally black and blue by the end of the birth. And still nothing changed. 7am Saturday morning, another check, another stall. I hadn't dilated any more. No more effaced, baby in the same place. Frustration swept over me again; we'd been sure when I hit 5, that would be it, we'd be moving and here we were again, stuck for half a day in the same place. More options were discussed. A few hours later, they turned off the pitocin. Similar to your sense of smell, your pitocin receptors can get "used" to the medication, so clearing them for a few hours and restarting can help. They'd break my water that afternoon, too, we decided - something had to give. I'd been in the hospital two nights now, and felt no closer to giving birth. *** My midwife, when checking me, asked if I had had a bowel movement that day. Since I hadn't "gone" since being switched to clear foods, IMO, because there is no fiber, etc to move the waste out, I felt somewhat constipated and she wondered if that could be interfering with my progress. I had heard from other doulas and patients that the hospital I was at would only give you stool softeners, but she actually asked if I'd be willing to try an enema. At this point, I'd have tried crack if you told me it would move the baby safely, so I agreed. The very nice nurse came in and explained that she'd prefer I "take it myself" because she could give it to me, but she'd really rather not. Can't blame her. I agreed, for both our sakes. She asked if I'd ever had one before - no. Then she gave me the instructions, which I still think are hilarious "Put this end in your bottom and then squeeze this part. Then sit down on the toilet." I did. It feels about as unpleasant as you're imagining. It helped and that's all I'll say about that. Jan, my original doula, recovered enough to come for a visit - what a blessing! Though I hadn't wanted to have my waters broken, I'd talked to her about it on the phone, as well as Teresa and the Husband, and I felt okay with it. This would be it - the catalyst that moved my labor along. So I was thrilled when a couple hours after they broke my water, Jan showed up. We talked about how getting to 5 centimeters is often the worst of it and here I was, there with no real pain - yay for me! We now had three birth balls and we sat bouncing like a Tigger convention, much to the amusement of the nurses. I had a few "gushing" incidents, the first of which when I stood up to head to the ladies room and so much fluid came out that I laughed out loud - it was like a bad movie special effect. Good news, because it means the baby is getting lower, we suspected. Jan gave Teresa a break and we spent some more time moving, bouncing squatting. I felt suddenly very tired, and Jan suggested trying a nap. It sounded good, so Jan left, knowing Teresa would be back when I woke up. I slept a little. Finally, finally, going into Saturday night, I was feeling contractions. Still not horrid, but getting stronger. This, I knew, was it. Finally. "Real" labor starting. I felt like every time they turned up the Pitocin, I got a boost in the contractions - it seemed to be working like it was supposed to! The contractions got stronger. I wanted to sit in the hot tub, but not allowed off of the monitors because of the pitocin, I had to settle for the shower. The husband sat on the toilet as I ran the hot water over my belly during the increasingly stronger contractions. I rocked and moaned a bit, as well, really proud on some level, when I wasn't in immediate pain, that I could handle these contractions this well. When the contractions got to the point that I knew I couldn't handle them if I got out of the shower, and knowing that they weren't going to let me deliver in the shower, I asked for Nubain. Nubain is a narcotic that basically takes the edge of the contractions, allowing women in labor to manage the pain, but not taking it away. I also worried that my window for a dose might be closing, as they won't give it to you after a certain point. My midwife came in to check me before deciding, and said "Nope. No real change. Still 5 centimeters and 50%" and folks, I lost it. That was one of the worst moments of my life. I'd been laboring for too long, getting through these waves of stronger and stronger contractions, knowing that I was doing it and going to get there and then this. I can say that in my life, I have had blessedly few moments of anguish, but this was one: my body had failed me, my knowledge had failed me, my strength had failed me. I even felt anger for God - I had done it all right, praying only for a healthy birth, and everything and everyone had let me down. I'd ignored my instincts and had an induction, and here I sat, certain that I'd be having a Cesarean birth - the one main thing I wanted to avoid, and I had done everything "right". I sobbed. I felt betrayed and exhausted and lost. I got to the bed, and I don't even know how. The midwife had suggested an epidural (one more thing on my "avoid if possible" list) and I felt like I couldn't think. I just wanted to push the baby out. The midwife explained that after all this time, if I didn't get real rest, I wouldn't physically be able to have the baby vaginally. The epidural, she felt, might also help my muscles relax more, encouraging more progress. The Husband and my doula agreed. I nodded. I hoped they were right, but I also feared this was the beginning of my route to surgery. Let me take a brief moment here to say that doulas are NOT anti-epidural. I can't speak for all of us, but in general, we are just against uninformed epidurals and the idea that you have to have one basically as soon as you reach the parking lot. There ARE reasons to have epidurals and times when a doula will suggest it, as in this case. Had I been the doula, not the patient, and been thinking clearly, I'd have absolutely recommended the same thing. I've been at births with and without them, and I don't "judge" anyone for the decision to have one. Anyway . . . I'd filled out the epidural release form earlier. When doing so, I'd crossed out the part about knowing that the hospital is a teaching hospital and that my epidural may be done by a resident, student or random passerby, and instead I had written in "ATTENDING ONLY". So, when nice epidural man came in, I of course said "Are you the attending?" No, he told me, just a resident. I explained that I wanted the attending physician. He said he'd done "plenty" of these. How nice for him. I insisted: Attending Only. Says so on my form. He warned me that I'd have to wait. "Okay. Thanks. Bye." My doula was impressed that I threw a doctor out of my room while in the middle of a contraction. Talk about empowering! I did have to wait - through one more contraction. Big whoop. I survived, and survived the epidural as well. During all this, my mother had arrived, and she came in just as the epidural took effect. Relief swept through me, as the pain drained away and I saw my mom. With the pain ebbing, it was suggest I get some sleep (as much as I could with them stabbing my fingers every hour) and we sent Teresa home to get some sleep. I had my mom and the Husband and we planned on just sacking out and snoozing. The midwife had also inserted an intrauterine device to monitor contractions, since I hadn't had good measurements on the monitor. My mom being there allowed the Husband to get some rest, she helped me with the bed pan and ice chips and rolling over. The night crept by. Early morning, I woke up with an uncomfortableness the epidural didn't help. Not having felt it before, I suspected it was the urge to push, but I couldn't be sure. I asked the nurse to get the midwife. She checked me and finally!! Progress beyond what I'd hoped for - only an anterior lip remained (think of it as being 9 and a half centimeters dilated). I knew what to do - what we call "blowing through" contractions, a way of dealing with the urge to push without pushing, since you're not quite there yet. Almost an hour later, I told the nurse to get the midwife, because I was going to start pushing with or without her. I couldn't wait. I gave Mom and the Husband baby-catching tips, just in case. Another midwife came in (shift change, again) and I started to push. Again, going against my birth vision, they insisted I use "directed pushing" (like you see on TV: hold your breath and push while they count to 10), but the midwife explained the reasoning and again, necessary. Sigh. I pushed for awhile, feeling ineffective. I needed to focus the pushing better. I asked for a sheet, using the towel trick or "Tug of War" with the squat bar and that combined with being able to see my progress in the mirror really helped. At one point when the baby's head was resting in the bottom of the birth canal, I said "THIS REALLY HURTS" which apparently was no suprise to the others in the room. I fell asleep between contractions, exhausted. Finally his head appeared and stayed visible. I knew we were there, and that overrode everything else. A few good pushes and this would be over. And it was. Griffin emerged healthy and strong, with his dark curls and perfectly shaped head, for a vaginal birth. My mother cut the cord. So that's the birth story. I can't tell you all the lessons I learned during those hours, it would double this post. I wish there were a way to see the what-if's - what if I'd waited until the next week to come in, what if we'd tried the other drug, even with its risks, what if I'd done more or less of one thing or another. But I rest in the knowledge that I did all I could do to get what was best for all of us. I avoided the surgery, I did what I could. I gained new appreciation for the Husband. And I had a perfect little boy. The End - no, the Beginning . . .