Monday, December 17, 2007

Birth Story

Thursday the 13th we were scheduled for a routine 41w non-stress test. I had agreed to it reluctantly in order to hold off on induction pressure. However, it snowed and the city came to a standstill, so we rescheduled for Monday. A. and I stayed up until 3am Thursday night playing World of Warcraft together (his 70 druid ran my 50 priest through Sunken Temple).

7am Friday I woke up with contractions. They were regular and somewhat painful, but all less than a minute long (usually 30-45 secs) so I didn't time their spacing. I tried to go back to sleep but they hurt, so by 9am I was up and having breakfast. They hurt less when I was upright. I started timing them using Contraction Master and they were 5-7 minutes apart, but usually less than a minute long. I read a pile of blogs and the archives of xkcd. I got into the bath around 11 or so. It spaced out my contractions a little, but it didn't make them hurt any less, so I got out after a while.

Around noonish A. got up. I let him know I was having contractions and that I thought it might be the real thing. He went online for a little bit and did his regular slow getting-out-of-grumpy-morning-state thing. The contractions were getting harder and were starting to really hurt my back. Around 2pm I got back into the bath. A. went for a quick trip to the grocery store; he bought me strawberries, juice, and candy to help get me through labour. I got out of the bath again when he was gone; again, it was spacing out my contractions, but I needed to be upright to handle them better. A. came back and started really helping me through the contractions. He also started being a little vain: shaving, trimming his hair, etc. He also had a strange little cleaning jag. Around 3 we started timing the contractions using Contraction Master again. They were 2-3 minutes apart, but still usually less than a minute long. I was making a lot of noise during contractions and A. was coaching my breathing. We decided to call the midwife. A. talked to her for a minute, then she wanted to talk to me. She asked me how I was coping with the contractions and I remember saying "They hurt, but I'm handling them ok... and here's one now... uhhh, ummm... A.!" and A. came running to take the phone away. He actually put the phone down and coached me through the contraction. When it was over he talked to the midwife and she didn't really give a lot of guidance. She said it was probably still pretty early, it was my first baby, it was up to us whether we came in or not. I found this a little disconcerting because I didn't know what we were supposed to use to make that decision. She suggested we pack our bags.

A. started packing but I needed him for every contraction and they were very close. I was losing the pace of my breathing and having a really hard time staying relaxed through the pain. So he'd put one thing in the bag and then come running to slow dance with me and coach my breathing. I tried sitting, kneeling, hands and knees, but only standing and swaying while leaning on A. really worked for me. A. asked me a few questions about what to put in the bags and I snapped at him; I didn't want to make any decisions or have to think about anything but getting through the contractions. When he was done packing he decided we had to get to the hospital. He tried to dress me between contractions; it was really slow as I would only put on one item of clothing (and sometimes only halfway) per contraction. He called the midwife back and told her we were on our way in.

I went to the bathroom and A. started calling cabs. He called every cab company he could find listed. He was getting increasingly frustrated as none of them would come right away. Some of them didn't answer; some of them directed him to other, busy numbers; some of them told him they could get us a cab in two hours. I don't know if it was the snow, the fact it was Friday evening, or if taxi service to our town is really that bad (we usually take transit). I laboured alone on the toilet for probably half an hour while he made calls. We tried to contact a friend but she's out of town at a conference. Almost no one we know owns a car. Finally I got off the toilet, came to the phone, and called my postdoctoral advisor on her cellphone. I told her quickly we needed a ride then passed the phone off to A.. She called her husband then called us back and said she'd come pick us up. A. coached me through a few more contractions while he got us into our coats. My advisor got to our place and after I had a contraction in the doorway we got into the car. I was still making a lot of noise, even though I was a little self-conscious about my advisor being there. She was freaking out a little (had never seen a woman in labour before) and kept asking if we should pull over and call an ambulance instead. She and A. made small talk between contractions, and it annoyed me but I participated a little anyway. She said seeing me in pain was really cementing her decision not to have kids and her husband was going to be upset with us. She sped and yelled at other drivers.

We got to the hospital around 6:30. At first I said I didn't need a wheelchair but then relented and took one. They're really comfortable! We went to admitting. They suggested we go right up to L&D and then send A. back down to do the admitting but we didn't want to be separated. I stood up from the wheelchair while A. coached me through at least two contractions while we got admitted. I threw up on the floor and then in the garbage can they quickly gave us.

We took the the elevator to L&D and met our nurse. I immediately didn't like her very much. We went to a triage room and she put me on the monitor. She spent a lot of time explaining how important it was that we get a good tracing and how I'd have to stay still etc. She told me that I was taking the contractions too hard and that I should save my energy for when I really needed it in later labour. A. told her I threw up and maybe I was approaching transition and she said "oh, is that what you think." She asked how much water I had been drinking and A. said I had been drinking juice. She said that's why I had been throwing up and I needed to drink water. She put her hand on my belly, said she was feeling a lot of "uterine irritability" and that I needed to drink as much water as possible. I didn't really object to drinking, so I drank quite a bit between contractions. I was taking the contractions very hard lying on the exam table, and was still making a lot of noise and arching my back between contractions. The midwife wasn't there yet because it was 15 minutes before the midwife shift change. The nurse left us alone and we checked the monitor for reactivity ourselves between contractions and decided everything was fine.

The midwife got there shortly after 7. I had met her once before during the hospital tour and gotten a good first impression, and her husband had been a student in our department at the same time I was and worked with a friend of mine. We talked about having a cervical check and decided to have one. She checked me and I was 5cm and fully effaced, baby at -2 station. She also noticed that I was very wet and confirmed that my water was leaking but I still had an intact forebag and they wanted to leave that to help cushion contractions. She got me off my back and onto my side. The nurse wanted one more contraction on the monitor so we waited for that. Then we were taken to a labour room.

The nurse had filled the jacuzzi tub for me so A. helped me get undressed and I got straight in. The midwife told me to keep drinking water and left us alone. It was really nice to have a tub deep enough that it covered my whole belly, but like the previous baths, it gave me some space between contractions to breathe but didn't help with the actual contractions. A. told me I was handling contractions standing up much better than in any other position so he got me out of the tub. I got onto the toilet and started shaking like crazy. It was really bizarre. I told A. I was cold and he dried me off, brought me a gown and a blanket, and I was suddenly not at all cold.

I was being extremely loud through contractions and sometimes swearing at the top of my lungs. I'm sure everyone heard me all through L&D and postpartum. Every contraction I swayed with A. and yelled to him how much it hurt. One contraction I felt the tiniest bit pushy, did a little poop-push, and my water broke all over the floor. Then I threw up about four times, all the water that the nurse had pressured me to drink (about a litre or so). There was water all over the floor, either amniotic fluid or vomit everywhere. I thought I needed to pee so I went to the toilet. A. was cleaning up some of the mess and I snapped at him to leave it but he wanted there to be a path for us to walk through from the bathroom. We just kept dancing through the contractions and I just kept yelling.

The midwife came back into the room and checked the baby's heartrate. She could only find it in one spot down low on my left side. Not long after that, I was really feeling like I needed to poop at the peak of my contractions. She noticed this and I asked if I was feeling pushy. We decided to do a cervical check. It took a few contractions just to get me over to the bed so she could check me. She said I was about 9.5 centimetres, or fully dilated except for a tiny rim on either side. I asked about the baby's station and she estimated +2 station. She told me to grunt and breathe down my baby during the pushy parts instead of pushing. I tried that for a few contractions but it was hard not to push instead. I was labouring standing up with one leg on the bed, leaning on A.. The midwife said I was probably complete and wanted to check me again. When she went to do it I started having another contraction and started screaming. She thought she had hurt me. After the contraction she checked me and said I was complete.

I found the pushing stage very challenging. I had heard that most people find it a relief, but I didn't. The pushing contractions hurt. Pushing felt awful, though I also absolutely had to push. The contractions were very close together, and I was screaming through all of them. I started pushing standing up next to the bed. The nurse was checking baby's heartrate during and between contractions. At one point she found a heartrate in the 80s and completely freaked out. She told me I had to get into the bed on my right side and have oxygen. Then she told the midwife she wanted a fetal scalp electrode. The midwife said it was probably just an artifact, but wasn't really standing up to the nurse. A. then had a little freak out of his own. He objected both to the oxygen mask and to the proposed internal monitor. I told him I didn't mind the oxygen, but I did not want an internal monitor. So he dropped the oxygen objection and flat out informed the nurse we did not need internal monitoring and would not have it. She got really huffy and told him he was endangering our baby and said something about how she was going to have to call a doctor in. He stood his ground and we did not get an internal monitor. I was kind of out of it and I'm not sure how it happened that the nurse wasn't in the room anymore but the midwife still was. Anyway, he told the midwife that the relationship with the nurse was not working and we would be needing a new nurse. The midwife quietly said she would see what she could do. She left the room for a bit, we got a new nurse, and we never saw the first nurse again. That was awesome and I'm really proud of A. for recognizing what we needed and firing our nurse.

I pushed for a little less than an hour, I think. It felt so weird. At first it was just like a really big, really painful, horrible poop, but then it just felt strange. The contractions were right on top of each other sometimes, and I screamed during some of them. The midwife held hot compresses to my perineum. At some point I made small talk with her about her husband between contractions; I'm not really sure why I felt the need to do that. I kept telling everyone how much it hurt, that I didn't want to push, and that I did not want a baby at all. But at least I kept pushing. I reached down and felt my baby's head at one point and it was much squishier than I thought it would be. The ring of fire was absolutely horrible and I screamed really loudly. The midwife gave me some sort of topical anesthetic. When her head was out I figured I was pretty much done, but I apparently still had to push out the shoulders. Then I thought I was definitely done, but it took another push to get out the body. She came out crying and cried for the first few hours of her life. They put her right on my belly and I held her for a while. I put her to the breast but she wasn't really interested. When I got a little grunty again the midwife had A. cut the cord. She said she wanted to give me Pitocin to help with bleeding but I declined, saying I'd only take it if I needed it. A while later she said she thought I was really bleeding heavily and she'd like me to take the Pitocin so I did. The nurse kept telling me that the placenta had no bones, which I think is an odd thing to say. A. told the midwife I would not be wanting to see the placenta at all.

I had two tears, one just a little superficial thing in the skin, one more serious but still first degree. The midwife gave me a local and sewed them up very slowly. At some point during that, A. took the baby to be weighed. After about 45 minutes the midwife showed me how to get her latched on. We refused bathing, vitamin K, and the hepatitis B vaccine, so all she has had is the PKU and the hearing test. We got released the next afternoon, after less than a day in the hospital.

The first day home was a lot of crying, but my milk is coming in and baby is much happier and sleepier now. I have her sleeping in her Maya Wrap right now, so I can type with both hands.