Teddy's Birth Story, Part 4

I've told this story twice today (Labour Day, no less), so it's time to finish it up on here.

A refresher: Part 1, Part 2, Part 3

One of the reasons I'd wanted to avoid an epidural was my fear that I'd be confined to the bed and unable to move around. The most efficient way to push, I'd been told, was to be upright and to let gravity help you along. I wanted that option, the option of moving around to find an optimal position for pushing.

At this point, however, my uterus had been contracting for well over 24 hours. It, and I, were pretty pooped. Though I didn't note it at the time, my contractions were coming further and further apart although they were lasting longer. This allowed me some time to relax and regroup between contractions. And the place that seemed to be calling my name? The birthing bed. I would drink water (and apple juice, when forced) between contractions, have cold compresses applied to my head and neck, and gear up for the next contraction while lying down. It was GREAT!

And I'm not kidding - the pushing was awesome compared to dilating. I could USE the contraction and work rather than just enduring it. It was a joy compared to the earlier part of labour.

The next few hours are a bit of a blur for me. I know that with each contraction, I would bear down and have 5 or 6 very long pushes. The doulas and Dave would alternate holding my legs during this, and they'd all cheer me on. A few moments stick out - Dave handing me a cold cloth for my head that was full of ice (and me making fun of him for it), Erin the midwifery student arriving and me greeting her, periodic progress checks. Ann and the doulas kept commenting on how calm and lucid I was, making jokes between contractions and having lengthy conversations. I just felt so great at this point - thank you, hormones! Eventually, a third midwife arrived. Melanie was there to minister to the baby and she was adorable and totally enthusiastic; she joined in as part of my cheering section. They offered me a mirror to check out the progress - I glanced down to see a bit of dark hair peeking out.

Unbeknowst to me, the midwives started to worry a bit that my contractions were slowing down. They suggested I get up on the birthing stool. I did, but it was so uncomfortable sitting there, so I begged to head back to the bed. Eventually, Ann let me know the score -- she was worried that the contractions were slowing down too much. "I know that you wanted to avoid pitocin," she said "but I think I'd be really useful right now so you can push out the baby and deliver the placenta."

"Ann," I told her, "I wanted to avoid pitocin early in labour because of the possibility of additional interventions afterward. It sounds like I need it now, so I'll do what you think is best." This became important as right about then, I started to bleed. Ann headed out of the room immediately to get a nurse to start an IV. As soon as she left, Melanie jumped right in. "Sarah," she announced, "you've been working so hard and I know that you can push this baby out on your own. I have an idea for a leg position where you can lie down and push more efficiently. Let's try it and I bet we can have this baby nearly out by the time Ann gets back!"

I shifted slightly and started pushing; Melanie's advice worked. By the time Ann got back with the nurse, the baby nearly crowning. And all I have to say it OWWW! The nurse was inserting the IV as he crowned. I let out this almost primal scream, as I could feel everything and the fact that I was bleeding.

One more terribly painful push later and I could feel the baby's head emerge. The bleeding intensified at the same time. It was the strangest sensation. I could here the baby making noise and feel the bleeding, but I hadn't delivered him yet. It was at that point that my uterus stopped contracting entirely.

Ann sensed this. "Sarah," she said. "You have to push even without a contraction. Erin and Melanie are going to push on your abdomen at the same time."

"OK".

Once the baby's head emerges, the team has 4 minutes to get the rest of the baby out before an emergency c-section is required. We used 1.5 of those minutes, but an emergency team got called in just in case. By the time they arrived, though, it was all ok. It was 11:01.

I pushed with all my might, Erin and Melanie pushed down on my belly and Ann managed to haul the baby out. All of a sudden, he was crying and slimy and on my chest, where he let out a lovely meconium poop all over both of us. It was an odd sensation - he was there, but when I tried to pick him up I pulled too much - his cord hadn't been cut and the placenta was still in situ. I was still bleeding, too, so that was distracting. But he was doing great. Dave cut the cord and they covered both of us with a blanket where we could snuggle. His apgar score was taken - 9.

The bleeding continued, however, and all of a sudden my uterine contractions became horribly uncomfortable. The pitocin, not used at all during Teddy's delivery, was needed to help with the placenta's delivery. Blah! The placenta emerged after 5 minutes, and Melanie took Teddy over to the warming area to be weighed and checked out, so Dave headed over there. He weighed in at 8 lbs, 4 oz and was 21.25 inches long.

Ann was cleaning my up - no tears, just shearing so only 2 minor stitches - while Teddy was getting evaluated. His second apgar score was a 10 and there were no problems. It was then that Dave took this picture, one of our favourites:

"What...just...happened??!?!? Where am I?!?!?" he seems to be saying.

The cleanup continued - complete with catheter to empty my full bladder. Not a highlight, but a necessary evil I guess. The bleeding finally stopped, but Ann felt I'd lost too much blood to get up. She told me that I'd have to stay in the bed for a few hours at least, and then they'd re-evaluate.

Within a few minutes, they brought Teddy over so that he could try his hand at breastfeeding. He appeared to latch on to both (note the 'appeared') over a 10 minute period. We checked out his massive hands (just like Dave's) and marvelled at his head full of hair. It was crazy - he was here! Dave snuck out to make phone calls to our parents; mine headed to town to check in on our cats (we caught them en route and told them to come to the hospital).

At around noon, Melanie and the doulas headed out - Melanie to office hours, the doulas to sleep. Ann gave Teddy a quick bath to get the meconium off of him, and she showed us how to swaddle him. We filled out more paperwork, then nursed a bit more. Ann let me know that she'd check back in regarding my discharge - possibly that night, possibly the following morning This was longer than the hospital stay we'd hoped for; had I not bled we'd have headed home later in the afternoon. She and Erin left just as lunch arrived. Boy - was I ever starving. Hospital food was mediocre, but I didn't care.

Not long after, my parents arrived. They marvelled over the baby and we made more phone calls. I LOVE this picture -- I'm on the phone with my Aunt Pat and it's only 3 or so hours after I gave birth. Hard to believe, no?

I had to stay overnight - boo! The day nurse was lovely, but the overnight nurse was totally overbearing and not at all helpful. Oh well - can't win them all. The next morning, additional blood was drawn and my platelet level was declared fine. Mei - our other midwife - came by to check on us an on breastfeeding (which appeared to be going ok...more on that later) and we were discharged by noon.

Man - I had such a great experience. Dave's support, the support of the midwives and of the doulas was so incredibly amazing. It went better than I'd hoped. It was difficult, but totally doable. And if we're blessed with more children, I will use midwives and doulas without a doubt!

And just for fun - here's a shot of Teddy, taken just over a month ago.

We love the little button. Thanks, Aunt Beth, for the t-shirt.

Teddy's Birth Story - Part 3

If you're curious: Part 1, Part 2

It's freezing cold and the air is crisp as we head to the hospital. I should note that getting my boots and shoes on was a total fiasco, what with contractions, water retention and my massive belly. I manage to get into the front seat and steel myself for an ugly car ride.

And ugly it is. With Dave driving and the doulas in their cars, I'm dealing with the contractions alone and it's not fun. In addition, I am feeling immense downward pressure while seated, and I'm effectively...ahem...'one-cheeking' it through each contraction. Happily, the hospital is only 7 km from our house. Dave drops me at the entrance and where Shannon and Zoia are already waiting for me. I insist on walking to the L&D ward, up a huge flight of stairs. I have to stop several times for contractions, which Shannon talks me through. Our progress is so slow that Dave manages to catch up with us after parking the car and hauling in all our stuff. At 6 a.m. exactly, we get to the L&D triage, where Ann is waiting.

Ann gets me settled on the same bed I was on several hours before. She's alone, which is unusual, as her student Erin is almost always with her. I discover later that, thinking this would be a consult regarding painkillers, Ann hadn't called Erin allowing Erin to sleep longer. She hooks me up to a monitor to check out my contractions and goes to check paperwork.

The contractions are just as intense as before, but still 6 or 7 minutes apart. Zoia talks me through them, and I can hear the monitor registering them. This is the only time I'll be on the monitor, actually. After about 15 minutes of monitoring (which seems like about 5 minutes), Ann comes with the doppler to monitor the baby's heart rate. This is where things get interesting.

The baby had been left occiput anterior for weeks, so Ann places the doppler on my left hand side, at hip level. Zoia and Shannon exchange significant glances as Ann shifts the doppler all the way to my middle and down way past my bikini line. Then, Ann asks if I'd like to be checked. I really need to know where I stand (not having picked up on the glance between the doulas) so I whole-heartedly agree.

So - Ann begins the check. I brace myself, expecting to hear "2 cm" and the subsequent discussion of interventions. Ann makes a surprised face and lets out an excited puff of air. "Wow!" she exclaims. "Sarah, you're at least 7.5 cm and 100% effaced.AND - there's still an amniotic sac around the baby's head; he's not even resting on your cervix yet!" I am absolutely gobsmacked. Ann checks again during a contraction; I have a bit of an anterior lip, but everywhere else I am at 8 cm.

"Ann," I keep saying, "I cannot believe this. Seriously, this is like a dream. I can't believe that I'm this far along."

"Believe it!" Ann exclaims. "We can admit you, break that amniotic sac and you can head into the tub."

And that's just what we do. I head into the room in which I'll spend the next 24 hours, and get into a gown. I hop on the bed, Ann breaks out the amnio hook and breaks the remaining membrane. In the meantime, Zoia is running hot water into the tub. Once it's ready, I hop in. It's about 6:30 a.m.

While in the tub, the contractions get more intense but they're much more manageable. The doulas suggest that we put on relaxing music; Dave and I had programmed a classical playlist on his ipod for just such a time. EXCEPT - he hits 'random' and EVERY song, it seems, starts with screeching violins which bounce off the tile walls. The doulas take pity on me and bust out their CD of 'spa sounds', which must be soothing because I really don't remember it.

In order to cope with the contractions, Shannon talks me through. She suggests getting a onesie so that I can 'focus on the baby' but as awful as this sounds, it's the last thing I want. I need to focus on Shannon's face and on breathing, as I realize that there's no way around the pain but through.

It's hospital policy that bloodwork get taken once a labouring woman is admitted. Unfortunately, this means that I have to have blood drawn while in transition. Ann tries three times to get a good vein but nothing doing. She brings in a nurse (whose name is either Julie or Nathalie); she hits a vein and draws several vials. I have two contractions during this time...what a treat!

During this time in the tub, I only have two contractions on top of each other. As the time goes on and the water gets cooler, I start having an OVERWHELMING urge to push. I insist on getting out of the tub, because I cannot stand to be lying down. Shannon and Zoia caution me that I can't push until Ann checks me, but Ann says that since my cervix is so ripe I can do a few test pushes. I sit down on the toilet and try. After three, I head to the bed for a check.

Ann comments on how calm I am during checks; they aren't fun, but they aren't all that bad. According to her, I am nearly 10 cm dialated; I have an anterior lip where I'm only 9.5. She suggests that I lie on both my left and right sides for 3 contractions each with no pushing. This proves INCREDIBLY difficult, but I get through. Ann checks again - the lip is nearly gone and she suggests I push through it while she holds it back. As much as that sucks, it only takes three pushes and I am cleared to actually start pushing in earnest. It's just after 8 a.m.

Teddy's Birth Story - Part 2

If you're curious - Part 1

While waiting for the doula(s) to arrive, I figure that I'll try the bathtub, despite the membrane rupture. Sadly, it doesn't do much for me. I displace too much water to really submerge, and the contractions themselves are not eased. "Eh," I think, "it was worth a shot."

At around 6 p.m. on the 19th of January, Zoia (Doula #1) arrives. She has her doula bag of tricks, and she spends the first 15 minutes or so observing me as I work through contractions (mostly standing up, swaying). She suggests that I try to get through contractions while lying down, and that I eat, though I have no appetite. Dave pulls together a variety of munchable things like hummus and pitas, and I try to snack on them during the contractions which are still 7 or 8 minutes apart. I don't eat much, but I do try.

I then settle in to a nest of blankets and pillows on the family room floor. Zoia breaks out the absolute BEST trick for this part of labour - counter pressure on my lower back, which combats the pain due to the pelvis expanding as the baby dropped lower. This, along with Dave holding my hands and encouraging me, helps immensely for the next couple hours. I am coping so well that I spend the time between contractions asking Zoia about her adolescence in Bulgaria and her wedding plans. As the time wears on, though, I ask fewer questions between the contraction and I rest more.

At 8 or so, the phone rings; it's my Mom. Dave and I had decided that, while we wouldn't lie if anyone called while I was in labour, we wouldn't call anyone with the news. Dave relays this fact to my Mom and promises to update her when things happen.

After 9, Shannon arrives. She's more hands-on than Zoia, and she wants to see evidence of the 'bloody show', etc. She's a little surprised that so little is happening on that front, as well as the fact that my contractions are still only 7 minutes apart. She also observes me for an hour or so, then she suggests that I take something to relax and help me sleep (as recommended by my midwife a few hours before). I take a gravol (the only meds I'll take; incidentally, it does NOTHING) and Dave and I head up to bed while Zoia and Shannon crash on the couches in the family room.

Dave and I are upstairs for about 20 minutes when the contractions start intensifying. I try to get through them on my own, but the breathing turns into moaning and the moaning just gets louder and louder. After 45 minutes or so, Shannon and Zoia head upstairs. They've noticed that the intensity of the contractions has increased (based on the moans) and they have devised a new plan. Shannon will do the first shift with me while Dave gets some sleep in the guest room and Zoia on the couch. Then, after a couple hours, they will switch.

Shannon hops into bed with me and my Chux pads and spends the next two hour applying counter pressure and giving me vocal cues while I labour. She starts guiding me in my moans, suggesting a particular tone at which to emit sound; I echo her. This is amazingly helpful. I write around during the contractions, and sometimes suggest changing positions. The position changes are awful, but Shannon reminds me that you need to go through 3 contractions in a new position to see if it's helpful. None of the positions I suggest feel more comfortable than standing up or lying down. The toilet contractions are not fun, but a necessary evil as I needed bathroom breaks ever half hour or so.

The contractions continue to intensify but do not get closer together. At around 2 am, Shannon tags out and Dave and Zoia take her place. Dave applies counter pressure (ineffectively at first; I am short with him and feel awful about it) and Zoia coaches me. After about half an hour, they trade roles. The contractions continue to get stronger and I struggle to relax through them, trying to snatch a few minutes of sleep in between. The tension in my body is leading to serious lactic acid build up and my muscles ache and shake. But the contractions do not get closer together. At around 3 am, the intensity level hits a high and stays there. I fight panic, as I start to doubt my ability to persevere, to get through.

Right around this time, Shannon comes back and gently verbalizes my suspicions - she is worried that I stalled in prodromal labour. She and Zoia fear that I may not be progressing and may be getting exhausted, and I totally agree. Shannon and Dave head to the phone to check in with the midwife on call (Ann) and describe the situation. She thinks the same thing, and suggests that, if nothing changes, we meet at the hospital at 8 am. to discuss options.

I labour for another hour in the bed, moaning and writhing. I develop a terrible case of the shakes. The contractions, however, continue to be 6 or 7 minutes apart. This period of time is the low point for me, frustrated and fearful that this, after nearly 24 hours, is only the beginning of the process. I fight panic and despair. Finally, I can take labouring in the bed no longer. I move to the toilet in the ensuite and stay there, trying to fend off the immense pelvic pressure I feel. Dave, Zoia and Shannon crowd in the doorway. It is 4:45 am.

"Guys, I am not sure how much more of this I can take!" are the first words out of my mouth. It's true; my uterus has now been contracting for 24 hours while I have only slept in 3-5 minute intervals in between the pain. I am shaking, on the cusp of exhaustion and my contractions are still not in the 'active labour' timeframe. I admit that I may need to consider interventions, specifically pain relief so that I can sleep. Despite my previously stated desire to avoid interventions, all three completely understand my views and are incredibly supportive. Shannon volunteers to call Ann again. Despite the late hour and the fact we'd called her one hour before, I acquiesce.

Shannon, I discover later, is totally stymied. The contractions are off, but I am showing signs characteristic of transition. She and Ann know each other well, having worked together hundreds of times. She fills Ann in on the situation and tells her "I need her checked!". Ann agrees that things sound a bit weird, and agrees to meet us at the hospital at 6 am. (Had my contractions been more consistent, Ann would have come to the house to check me there.)

Shannon relays this info, and I develop a new scenario in my mind. I figure that I'll get admitted at the hospital, and will likely start getting Pitocin. As exhausted as I feel, I am sure I'll need an epidural; I hope that it will not escalate to a c-section. My prayers for strength, happening throughout the labour, intensify at this point.

Dave and I get dressed (Dave throws on clothes over his pjs) and we grab the car seat and hospital bags. The preparation takes time, as I keep having contractions. We bundle up against the temperatures (in the - 20 range), grab our bags, and get into our cars. It is 5:45 a.m.

Teddy's Birth Story - Part 1

And here we go - Teddy's birth story in as many installments as it takes.

The weekend of January 17th and 18th, I'd been feeling off. Now, I'd been reading 'birth stories' for years, so I knew that I might be heading towards delivery. I also knew the Oxytocin levels peak around 3 a.m., so contractions could kick up in the night only to die down with the light of day. This is what began happening that weekend; irregular contractions in the night, nothing but Braxton Hicks during the day. On Sunday the 18th, I felt particularly awful all day, with Braxton Hicks contractions all.day.long. I checked in with doula Zoia at about 8 p.m., just letting her know what was going on. I also hit the sack early, just in case. I got up about 1,000,000 times in the night to go to the bathroom, but that was no different than usual.

At about 5:00 a.m. on Monday the 19th, I brushed off the sleep and realized that the contractions I'd been feeling all night were fairly regular and increasing in intensity. I started timing them -- consistently about 8 minutes apart. Off to the bathroom I went...and noticed a bit of blood. Since I'd had no blood since my last period on April 15th, 2008, I figured that this might be it.

I let Dave sleep until 7 (his usual wake-up time) timing the contractions all the while. They got a bit closer - 7 or so minutes - but were still manageable. When Dave woke up, we decided he'd work from home for the day, and he took over the timing. I had some breakfast, and made my first key discovery -- the only position in which I was comfortable during contractions was STANDING UP. This would be consistent throughout labour. So much for all the time on the birthing ball, and building up strength on my hands and knees!

After breakfast, I felt the urge to move around. Being January in Ottawa, outdoor walking was not really an option (especially since none of my winter coats could close over my enormous girth). I wandered around the living room and dining room for a while, but ultimately decided to walk on the treadmill to 'get things moving'. I'd been on the treadmill for about 5 minutes when I felt a slight gush. "Uh oh," I thought to myself. "I haven't had incontinence at all during the pregnancy. Is it starting now?" Then I realized - my water was breaking! Little spurts came out during contractions, though, and not any other time. I suspected a hind water break, but didn't think too much about it.

At this point, we paged our midwives and discovered that Ann was on call. She agreed that it sounded like my water had broken, and asked us to meet her at the hospital to confirm. We arranged to meet at the hospital around 11 for a check.

By the time we'd arrived at Montfort Triage, it was clear that labour wasn't firmly established yet; my contractions slowed down as I moved around. They were also still manageable. Erin, the midwifery student, hooked me up to the monitor to see how the contractions were, and she listened to the baby's heartbeat. The heartbeat was strong and consistent (another trend), but the contractions weren't. Ann came in and did a swab to see if amniotic fluid had been detected. After the swab showed a positive, we discussed our options.

Based on the irregular contractions, it was clear that true, active labour hadn't started yet. Ann didn't want to do a check because she didn't want to risk introducing bacteria into the uterus due to the ruptured membrane. She sent us home, saying that if labour kicked in before 8 a.m. the next day (i.e. 24 hours after the reported rupture) we'd be in business. If not, we'd come back to the hospital and discuss next steps.

We headed home from the hospital, contractions having started up again. Back in the house, I set up a nest of blankets on the floor in the family room; Dave hung out on the couch. We kept timing contractions, which were once again consistent at 8 or so minutes apart. At this point, it was about 2 p.m. I fielded a call from Shannon, our other doula, who advised both of us to sleep.

Dave managed to doze off for a while on the couch, but I was getting more and more uncomfortable. I alternated lying down between contractions with standing up and swaying during contractions. And I just couldn't get comfortable enough to sleep.

As day turned into evening, I began to realize that my coping mechanisms weren't cutting it any longer. Dave awoke, and I asked him to call Zoia and ask her to come over and help out. When we called, she let us know that she was already heading out the door to come by. The sun sank as we waited for Zoia to arrive; Shannon would be heading over a couple hours later. We checked the clock - 5:30 p.m., and contractions were consistently 7 minutes apart.