Tuesday, August 25, 2009

The Birth Story

Birth stories are not everyone's cup of tea. And it seems that only once you've been through it are you interested in hearing about the experiences of other women, or think to ask about it. That's true of me, anyway. But I have had a few people ask for further details about the labor and delivery of Dominic Pax, so if you care to know more, read on.

As many people know, Eric and I loved our Bradley birthing class, geared to natural childbirth. I still consider it the best thing we did to journey through pregnancy and prepare for bringing our son into the world. I wholeheartedly believe, due to everything I learnt in this class and through other resources, that having an unmedicated labor and vaginal delivery, is the best for mother and child, and especially the child. This isn't the place for a lesson on hormones and endorphins, and all the advantages of natural labor, but I would like to say that it isn't about the mother being a martyr, or vanity, or medals being handed out. It's for the child. Trust me, I'm a wuss, and if I didn't think it made an iota of difference, I wouldn't have tried for it.

Having said that, I have also always maintained that I am grateful for medical technology where necessary, and I am not pro natural birth at all costs. Having medical interventions in my labor and delivery turned out to be very necessary and timely, and that is something the Bradley class taught us too - how to be in control, to understand what was happening (even under these intense circumstances), and to be empowered to make decisions for the good of everyone involved (i.e. mother and child). I never, not once, felt panicked, or forced into anything, or didn't understand what was happening and what the implications were for each decision.

So, with that long-winded opening chapter out of the way, here's our birth journey:

Dominic Pax was born via c-section on Monday, August 10th, 2009, at 10:33pm. The previous Thursday was the last time I had a somewhat decent night's sleep. Early pre-labor symptoms started on Friday with a chronic, dull, lower back pain (new for me) which gave me a very fitful Friday night's rest. I wasn't able to nap much on Saturday, and early labor contractions started that evening at 7pm (right as I was walking into a friend's birthday party). These came and went during the evening, but by the time I went to bed were on 15-20 minute intervals. They weren't too intense, but were enough to keep me awake, so it's safe to say I didn't sleep at all for more than 10 minutes at a time that night. They continued on throughout the day on Sunday, and at about 10:30pm on Sunday night I was in active labor, with the contractions coming more frequently and certainly more intensely. I'd been sleeping in the guest room for a while now, and woke Eric up around midnight, about 20 minutes after I lost my mucous plug. I knew this was it now. I labored for a little bit, with Eric timing the contractions, and then we felt it was time to call Susan, our doula. Susan was at our place by 1am, and was amazing. She helped with different positions, trying to get me to eat and drink, and being a support for Eric. At one point we called Kathy, my midwife, who also let us know that the one room at the hospital with a labor tub was not in use and would be available at a certain time. We wanted to continue laboring at home for as long as possible but also wanted to make use of the labor tub (sometimes known as 'the midwife's epidural'). Labor was pretty intense, and I threw up at least a couple of times. It was blue, due to all the Gatorade I'd been drinking!

Around 5:15am we got in the car to make the 15 minute drive to the hospital. The big double doors opened wide to the entrance to the women's hospital, and with the nurses at the reception desk watching us approach, and me leaning on Susan's arm (Eric was parking the car), I remarked that I felt like a bride walking down the aisle. Well, a bride who stops to breathe through a contraction every few steps!

Kathy arrived the same time as we did at the hospital - once in the labor room we were hooked up to the mandatory external fetal monitor to see how Monkey was doing. Kathy was concerned about his heart rate, and knew somehow I was terribly dehydrated (due to the throwing up) and didn't want me getting into the tub before rehydrating as the warm water would only exacerbate things. So after all my chugging probiotics to avoid an IV for Group B strep, there I was, getting an IV for fluids right off the bat. Almost unbelievably, it took them TWO HOURS to get an IV in me. My pregnancy swelling and dehydration (tiny veins) made it nigh impossible for them to find a vein, and it took two nurses, someone from IV therapy (the big guns), and finally, an anesthesiologist to put in an IV. Bear in mind my contractions are continuing to come thick and fast during these two hours as I'm being poked and prodded. Not fun.

The good news is that I had already dilated to 7cm upon arriving at the hospital, and after 2 hours in the labor tub, I had dilated to 9cm. Only 1cm to go! BUT then I stalled. I continued laboring for 2 more hours, with the contractions becoming even more intense, and somehow, less effective. Nothing more was happening, and I was at the end of myself physically. Eric and I had a pre-determined code word for 'yes, really, I do mean it, I'll take an epidural'. It took me a few times of actually saying 'elephant' for him to really believe me though, but even though I was disappointed it had come to this, I couldn't go on. I was just too exhausted, and I knew that sometimes in those cases an epidural would allow the mother some much needed rest, to continue laboring. I was given the epidural around 11:30am that morning, and was able to nap and rest for a number of hours. During this time I dilated to the requisite 10cm, the baby descended a little, and around 5 or 6ish pm they turned down the epidural levels somewhat in order for me to feel the contractions again, and know when to push.

I started pushing at 7pm, and could intensely feel the uncontrollable urge to do so whenever a contraction came on. For 2 hours I pushed, and it felt like 30 minutes. But the baby wasn't descending too much, and I think only about a 3rd of his head was being pushed through the pelvis (so he did have a little cone-head, despite being a c-section baby!) At this point, Kathy, the midwife, brought in the back-up ob-gyn to check me, and while they both agreed that I could continue pushing if I wanted, they weren't sure it was going to do much good, and I could consider a c-section. Monkey's heart-rate, although not distressed at this point, wasn't as optimal as it had been during the previous hours, and this was something to think about too. Honestly, I didn't think too hard about it, and said "I just want to see my baby now, let's do the c-section." It was an easier decision for me than it was for Eric. He knew how badly I'd wanted a natural birth, and we'd gone so far off the birth plan. Thankfully Susan was there, and could be an emotional support for Eric - as he felt he had to seem strong in front of me.

This next part was the most difficult for me - the epidural levels couldn't just be turned back up, so for about 45 minutes as they wheeled me to an operating room, and prepped me for surgery, I could feel the urge to push, and had to do everything in my power not to do so. It was horrible, and the portion of my labor of which I have negative physical memories. In all honesty, I do not have ANY negative physical memories of the unmedicated labor, and I'm sure this is due to the endorphins and hormones that are released when artificial drugs aren't introduced to one's system. I know they were intense, and Eric tells me it appears as though they were painful :), but I just do not remember how they felt.

Back to the c-section: Eric was with me during surgery, and saw Dominic Pax being lifted out, and was able to cut the umbilical cord. But, our baby's breathing was labored, which the medical crew initially supposed to be meconium in his lungs. An x-ray revealed however that he had a spontaneous pneumothorax (a tear in the lung, creating an air pocket in the lining of his lung), and they whisked my baby off to the Infant Special Care Unit (ISCU). I remained on the table for about an hour and a half after that though - the ob-gyn nicked my bladder during the surgery, so they had to get the urologist (sleeping in his bed at home) to the hospital to stitch me up. Dominic Pax was born at 10:33pm, and I got out of surgery after midnight. Once out of recovery, about an hour later, they wheeled me past the ISCU on the way to our room. I was flat on my back so didn't have a good view but was at least able to somewhat see my baby, although it was heartbreaking to see him lying under an oxygen tent with an IV and lots of little monitor type things stuck to his tiny body. I was still foggy from surgery though, so the magnitude of not being able to hold my baby and start breastfeeding immediately after birth didn't hit me then. (It hit me the next day though, and every day for about 2 weeks after that, and was something I really cried about and struggled with for a while.)

The following day my wonderful day shift nurse, Pai, helped me into a wheelchair and we went down to see my son. An ISCU nurse took him out the oxygen tent for 30 seconds and held him near my face so I could kiss his little head. I have a private photo of that moment, tears streaming down my cheeks.

Even though he was in ISCU I wasn't terribly concerned about the implications. The doctors and nurses had assured us that this tear (they aren't sure how they occur) wasn't a developmental issue and would resolve within 5-7 days. Praise God, it resolved within 36 hours, and by Wednesday evening he was released from the unit and brought up to our room, his little lung completely whole. I went down to the ISCU again on Wednesday morning though, and at that time was able to hold my boy for the first time, and even fed him a little from a formula bottle.

It was so hard having to be separated from him for so long though, and initially I felt very disconnected from everything. Again, this wasn't the picture we'd envisioned, even with a c-section outcome. We were in the hospital for 5 days, and thankfully, after a few days of being at home with Dominic Pax, all the holding and cuddling made up for it, and somehow that time was redeemed. Also, thank the Lord, despite being given a pacifier and bottle-fed formula in the ISCU (of course he had to be fed and comforted, not being able to be with me!), he transitioned to breastfeeding wonderfully, and he is to date an exclusively breastfed baby. No nipple confusion for our boy! And he is held and carried ALOT, and sleeps in the co-sleeper attached to our bed, within sight and smell of mommy - so hopefully any lingering memories of lying alone under that oxygen tent are long gone, and replaced by loving feelings of warmth and closeness and security.

So, there you have it. Our birth story. Mine, Dominic Pax's and Eric's. It was a bit of a rough journey, but at the end of the day, we have our precious son, and now we're on a new journey together.


Our little angel, in the ISCU.


Susan visiting the next day - she truly was an amazing support and encouragement (during the pregnancy, during labor, and even in these post partum days). She was with us for over 30 hours during the labor and delivery, and we are deeply grateful to her.

Holding Dominic Pax for the first time.

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