November 11, 2007

Birth Story

Here, finally, is the long and short of it. For the short, just scan the headlines...

November 1
8:30am - Appointment with the perinatologist

We were sitting in the waiting room when the peri came out of an exam room. He took one look at me and from down the hall said "Still pregnant?!" He'd expected me to be delivered when he sent me to the hospital on Monday. When my scan was done he said the baby was measuring smaller for gestational age than before and he believed placental dysfunction was becoming a more serious concern. Before he told me what he his recommendation was, I saw him type "deliver within 48 hours" into the computer. He had me wait in his office while he called my OB. He said they couldn't get me in that day but to go home and wait for a call to schedule an induction for the next day. When we got home, there was a message from the OB's office telling me to go directly to the hospital, and that my doctor would let me know what the plan is when I got there.

We got our bags ready, I wrapped up some things in my office, and off we went. On the way there I asked J "What are we going to name this baby?" He said "Well I think we have to think about that." Me: "How about now?!!"

11:30am - Admitted to triage
No one knew what was going on when I got to the hospital. The OB at the office had called the OB on call at the hospital, but he was in surgery when we got there. I hung out in triage yet again waiting to hear what was going to happen. I was beginning to get so irritated with being sent back and forth to the hospital, especially after the 24 hour stay just two days before, and with the back and forth between all the doctors different opinions, that I was feeling a little more like maybe it wouldn't be so bad to get this over with. I'd been sent home with discharge papers four times now that read at the top "Discharged with: no babies."

When my doctor got out of surgery he came to talk to us about our options. He explained that they (the OB's) prefer to wait until 38 weeks; they just feel it's safer. He explained the potential risks of delivering at 37 weeks. It was a little frightening because I'd understood that 37 weeks was considered term, but here was the head doc from my practice explaining that no one really knows when between 34-38 weeks each individual baby will really be term, so at 37 weeks there are still risks like "blowing a hole in the lungs..." and other stuff too scary to remember. On the other hand he said, it was hard for him to recommend going against the peri's recommendation, since he's the expert. He asked me what I wanted to do. I said I didn't want to be the one to decide, I wanted my doctors to tell me what they thought was best. He said he leaned toward doing the induction. Ultimately I have had the most trust and confidence in the peri all along, so at this point I was comfortable with it.

2:30pm - Admitted to Labor & Delivery
Three hours after checking into the hospital and laying on that stretcher in triage, I had my own room. It didn't have the ugly wallpaper of the room I was in Monday and Tuesday, but it also didn't have the window that had allowed me to get a web signal on my iphone - bummer.

3:30pm - Started Cervadil
An hour later the doctor came in and inserted the cervix-ripening Cervadil, since I was still only 1cm dilated and 50% effaced. Not comfortable! He explained we'd let this work for 12 hours and then I'd have an hour off before we started the pitocin. During the whole 12 hours of Cervadil I'd need to be on the monitors.

It was a long afternoon. I watched TV and finished my Carl Sagan book - the one I'd been reading on the stretcher at the fertility clinic when we did egg retrieval back in March. J went home at some point to take care of the dog and I got a half hour nap. He came back around dinner time and we played gin. At some point he told me he was ready to agree to the name Piper, which for some reason I've loved since I was about 12. We still hadn't settled on a middle name though. We talked about some options but we really weren't sure.

My mom came by soon after and we all hung out until I decided I needed to sleep, which never really happened. They went home and I continued to have nurses come in every half hour and stick me, ask me questions, and who knows what else. Sometimes they came in just to introduce themselves after shift change. Great, thanks. Please go away.

November 2
12:00am - Contractions

I didn't realize what they were; thought I was just missing my fabulous body pillow. I'd been getting uncomfortable and kept switching positions, knocking off my monitors, trying to find some way to sleep. I'd shift around and get more comfortable, then need to shift again. It took me a few hours to notice the pattern and realize it was my position changing making me more comfortable, it was the contractions ending. At this point they felt about like bad menstrual cramps; those months when you've had way too much chocolate and wine and haven't exercised in way too long. More discomfort than pain.

3:30am - Done Cervadil
At the end of the 12 hours, the nurse came in to remove the Cervadil but it was already gone; fallen out. Not a problem she said, but I was still only 1cm dilated despite the contractions. Annoying. I was given an hour off the monitors during which I took a shower, which felt fantastic. Also good thing I took advantage of it because I wasn't up to taking another one the first day or so afterwards.

4:30am - Started Pitocin
I was started on a low dose of the pitocin. My contractions were about 1 minute long every 5-8 minutes at this point. They pretty much stayed this way for the next five hours while the nurses continuously ramped up the pitocin amount.

Although the contractions stayed about the same frequency, I started getting more uncomfortable. It was still not really painful, but it was now like my worst ever menstrual cramps; the kind you might have every few years that make you need to spend a day in bed. I asked the nurse when it would be time for an epidural. I had thought there would be a point when they came and offered it. I remembered something about waiting until you're 4-5cm or something, to let your body do it's thing first. She explained that they don't really do that with pitocin inductions. For one thing, pitocin contractions are notoriously much more uncomfortable, and also since it's not your body in charge anyway it doesn't matter, they will still be controlling things with the pitocin regardless of what you're feeling.

So basically she said most doctors would let you have the epidural whenever you wanted. I told her I still wasn't sure when I should ask for it. She suggested getting it early, before you feel like you need it. It's easier to have the actual proceedure when you're in less pain and everyone takes a different lngth of time to respond to it, plus you never know when the anesthesiologists will get booked up. I told her I'd like to request it as soon as it was allowed then, and the guy was there in minutes.

9:45am - Epidural
I had been pretty calm about everything up until this point, but I was nervous about the epidural. The anesthesiologist came storming in pissed off at another doctor for rescheduling some other procedure and fuming about it to my nurse. She calmly had me sit on the edge of my bed with my back exposed and hunched over while he continued to rant and rave about "how DARE he ask such-and-such..." He scrubbed the iodine over my back with a vengence and may have removed a layer or two of skin. The nurse gently whispered instructions to me "hug your pillow in front of you, and when I say so, tuck your head and chin all the way down and push your back out towards him...okay, now." And it was done. It felt sore going in, but went away quickly.

I tend to be pretty sensitive to drugs and the epidural kicked in immediately. I felt warm and tingly, but I also got major jitters and felt like crap. I started to regret asking for the epidural so soon since I wasn't yet really in pain, but those side effects had subsided within 20 minutes and ultimately I think it was best I had it early and had loads of time for it to sort of settle in. Just like I'd been told I would, I had to laugh at the monitor when I saw the next contraction and felt nothing. Ahhhh. Then nothing happened for basically the rest of the day. Oh except the catheter, which SUCKED. I don't know why it hadn't occurred to me I'd need one of those, but eventually I didn't feel that much either.

7:00pm - Water broken
After 14 hours of pitocin, contractions were still 3-4 minutes apart, as they'd been pretty much all day. I was now 2cm. A different doctor now on duty (the third since I'd arrived), decided it was time to break my water. It really does look like a crochet hook. For some reason I decided this was it. There was no turning back now! It was beginning to look like I might actually have a baby. The doctor gave her guess: 7am. She asked the nurse what she thought. "You may be right but I'm not going to say 7am, just because that's too cruel. I'll say 2-3am." Sounded like they were expecting things to get more painful from here on in. And that's basically the idea with breaking the water, without that extra cushion each contraction can put more pressure on the cervix. Hopefully things would advance a little more quickly.

10:00pm - Feeling contractions
Twelve hours after starting the epidural, I was still numb but the contractions were now strong enough that I could feel them through the epidural. Again they were more uncomfortable than painful, but I was aware of them, and I'd finally made it to 3cm. J and I fell asleep.

November 3
1:00am - Active labor

Around midnight the contractions became strong enough to wake me up, and they got stronger over the next two hours. Around 1am I started trying to wake J up from his nap on the very uncomfortable bench in the room. He's a heavy sleeper and kept opening an eye to check on me then dozing off again. By 2am he was finally awake for good. By then the contractions were strong enough that I has having to try some of the breathing techniques from class. I hadn't been big on all that stuff because I knew I was planning to have an epidural, but there was an exercise in class where we had to push with our hands against force with and without focused breathing and I was amazed at how much difference the breathing made, so I gave it a shot. It really helped. This will sound so corny but with each breath out I was envisioning my cervix widening a bit more, as if I was blowing it open. I don't know if I was actually making any progress with that, but it made all the difference in getting through them.

This went on for about 20 minutes before I started feeling like I wanted to push. More specifically, it felt sort of like I wanted to poop. At that point I was fighting the urge to bear down, so at 1:30 J went to let the nurse know. The contractions didn't look any different on the monitor so they weren't aware anything had changed. At 1:45 she checked my cervix and I was fully dilated-she said it waqs time to push. My nurse was amazing (thank you Staci, where ever you are!), and walked me through exactly what I needed to do; taking a huge breath in at the start of every contraction, then holding it in while I pushed as hard as I could before exhaling--about three of these during every contraction.

3:06am - Delivery
We kept going like this for probably another 30 minutes, not more than 10 contractions, before she went to get the doctor, who was stunned that I was ready already. When the doctor came in, I pushed just a few times before the big one. I felt the head pop out and I could tell it was tiny. The doctor and nurses were exclaiming things like "oh it's a TINY one!" I looked up at J's gaping dropped jaw, staring down at the baby half way in and half way out. I think they might have suctioned her nose and mouth before I finished pushing her out but I'm not sure.

Next thing I knew they put her right on my lower belly and were wiping her off. I was staring down at her and thinking "No I'm infertile. I don't make babies." I was looking at her, knowing she had just come from somewhere inside my body, but not remotely able to absorb the idea at all. I was happy, I was proud of myself, I felt excited and relieved, but I did not have this sudden magical moment where I finally Believed. It wasn't that anything was missing. It all felt perfect. It was still just so unreal.

They picked her up and washed her off and did the usual stuff (all very fuzzy now). I think it was during this time that they delivered the placenta. Finally we got the answer to the big question: the placenta was very small and not looking good, so the early induction was very much justified. The perinatologist had been right, and the OB confirmed it was a good thing we delivered when we did. She would thrive much better out in the world than in there dependent on that thing. Whew, major relief. But then the doctor had a problem stopping my bleeding. There was talk of sending me into surgery if they couldn't stop it. After a bit longer pressing on my abdomen, another peice of placenta came out, and the bleeding finally stopped. I'm not really sure what this means but will ask more about it at the 6 week check up, but basically we're felling really good about the induction decision.

They brought her back to me swaddled and with a hat on. This time I got to hold her close and have a better look and she was the most beautiful thing ever. It was still a few days before the reality of it began to set in and I'm not sure I still totally believe it, but I can say for certain that I'm loving every day of it.

And that's how we got our third 3rd (J and I also were born on the 3rds of our birth months), eight months after egg retrieval which, incidentally, was on 3/3. All in all, labor and delivery was really easy. I know, I know. I too have smirked at women who say this and whispered sideways to a friend that people with a story like that should just keep it to themselves. No doubt delivering a 4lb. 13oz. baby is a walk in the park compared to what most women go through. I also think getting the epidural early (thanks Holly) was key. The next few days were anything but easy, but I'll save that for another post.

18 comments:

Bumble said...

Oh Sarah, what an amazing story and you made me cry when you said "No I'm Infertile, I don't make babies!" Yes you do, and you make beautiful ones too! It sounds like the L&D was long but not too bad, and I too will ask for the epidural early! No heroics from me I'm afraid. You say you still felt the bigger contractions near the end, even with the epidural, were they sore or just like pressure? Why did the catheter suck, did you feel it even with the epi? Sorry for all the questions! And congrats again!! xxx

Rachel Inbar said...

How exciting :-) Thank you so much for sharing the birth story. Easy? Ohmigosh. It sounds long and really tiring. Personally, I don't think the size of the baby makes that much difference (maybe it makes the pushing easier).

Congratulations!!! Make sure to take lots of pictures :-)

twirl said...

Really? That didn't sound easy.

So glad to read your story!

The Momcaster said...

CONGRATULATIONS!!!

Thanks for sharing all the details... Piper is lovely...

Valerie said...

What a wonderful birth story. I cried too when you said no I am infertile I don't make babies. I just adore her name too.

JJ said...

Thanks for sharing this beautiful story--and lucky 3's!!

Debbie said...

That is an amazing story, thank you for sharing it. Enjoy every minute with beautiful Piper.

Congratulations!

(btw that did not sound easy at all)

Nearlydawn said...

Wow, how wonderful. I appreciate you sharing your story, so much. There were many tidbits of info in there for me to file away... I'm pretty scared of the labor part. :)

You must be so overjoyed to be able to hold your little girl.

Congratulations!

K77 said...

I'm so glad you got an easy labour/delivery, I think every infertile deserves that much.

Tam said...

Congrats sweetie, what a beautiful post to come back to. Your little girl is just lovely, enjoy her!

You've done it sweetie, you've got a real live baby, way to go my friend!

Hugs xxx

HOLLY said...

YEA!!! I love your story and what a great thing you will have to share with Piper when she is older!! Her whole birth story from the VERY beginning!

My Reality said...

I love that you finished your book that you were reading during your cycle. And I love the 3's.

I am so happy your daughter is here and that it went well!

Mands said...
This comment has been removed by the author.
Mands said...

What a beautiful and honest account. I have always loved your writing. You give the rest of us hope and take a lot of the scary-ness out off the whole birth thing.
Once again, congratualtions to you both.
And yes, I cried too.

Angie said...

What an amazing story. I hope mom and baby are doing well.

Kate said...

Sweet lord, woman, where you do find the time to write long posts like this? :) I am impressed.

So glad to hear your experience was positive. I am sure you were a rock star through all of it. I laughed when I read about the nurses coming in every few minutes to check on you. That--and the blood pressure cuff going off every 15 flippin' minutes--were incredibly frustrating to me too.

I am so glad Piper is here safely. Will we be seeing more pictures?

tipsymarie said...

She is an absolutely beautiful baby! Thank you for posting your birth story. I love reading these, you know, just in case.
And I love the name Piper! So cute.

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