She's Here!! (8 days late...)

Short version: 12 hours labor, epidural, baby sunny side up, 45 minutes of pushing, born 3:44 pm. 8 pounds 14 ounces. Pictures to come shortly once I get them off the camera. 

Long version: 


(Seriously don't read it if you don't want to know about my cervix. You've been warned!)
This whole delivery was bizarrely parallel to my first, but with far better outcome for me, and less trauma to everyone.

Friday the 9th I was a week overdue. I was sore and exhausted and beyond done being pregnant, and I felt like the only way I was ever going to start labor was for my water to break. I had my 41 week appointment that morning, and we'd scheduled a 42 week check for the following Thursday and induction for Friday the 16th.

Fun aside: January 10th was the inspection resolution deadline for our house, so we knew we were going to have to sign some things that day (thankfully, electronically).

We went to bed at about 11 on Friday night, I was timing contractions and noting that they’d been every about 7 minutes for a couple days (whee). I woke up at 3:30am on January 10th with a decently intense and painful contraction, but didn’t really think anything of it because honestly that was sort of the norm by that point at 41 weeks 1 day pregnant. I peed and came back to bed at 3:38. A few minutes later I had another contraction, this time accompanied by a rather enormous gush all over the bed. I woke C up with my exclamation of “Ohmygod, my water just broke!” and continued to gush all over my side of the bed while he went and grabbed every available towel in the bathroom. I tried to go back to sleep for a little while, but the contractions were immediately so painful and intense that I was already having to focus through the pain and really work to let them accomplish what they were doing, rather than tense up. I had to resort to making “Aaahhh” sounds and trying to stay open and relaxed starting almost immediately. At about 4 I gave up trying to get back to sleep, and we left for the hospital 45 minutes away at a little after 5am. Turns out that 45 minutes to the hospital, even with no traffic at all (yay Saturday morning?) REALLY sucks when you are in active labor like that. I tried to eat and drink a little but threw up pretty fast, and I decided that I hated every bump in every road, and every red light was out to make me miserable.

We pulled up to the hospital and C went and got me a wheelchair, and they directed us to the Mother and Baby unit, where the nurse immediately sent us to triage (in my head I said “Are you fucking kidding me? Triage? Really?” but once the nurse there saw the puddle between my feet and how much I was actually in labor, she brought me to a labor/delivery room. We were set up and I was being monitored by 6am. Because Dee's delivery had been only about 30 minutes after my water broke, we thought that maybe this one would be quick too, so by about 7am the room was set up. They monitored me for a little while and started the IV antibiotics because I was Group B Strep positive. I also got an ultrasound to verify that baby was head down, which was apparently hospital procedure even though I’d had an ultrasound the day before to check fluid levels and had already verified that she was head down. I was 5cm dilated, and having very frequent and very painful contractions. I was doing my absolute best to surrender to them and let my body work but my hips and low back were feeling every ounce of pain, and my pelvis was objecting mightily (I had symphysis pubis dysplasia/SPD for the last 8ish weeks of my pregnancy). The jetted bathtub became my best friend for about an hour.  The tub had jets labeled “feet” but which hit my hips absolutely perfectly to ease the pain and give his hands a rest. C helped me out at around 8am. I was feeling pushy and they checked me again. 7cm.

I was put back on the monitor (UGH) and they noticed that the baby’s heart rate was not doing well with my intense contractions. I was really, really thirsty, but because I’d been throwing up I just asked for ice chips to chew on. Around 9am they put in an internal monitor (poor girl has scratches and a scab from it still 3 days later) to keep better track of her heart rate. I also got an oxygen mask around this time. I was able to labor on my knees in a supported kneeling position, which felt good but C still had to use strong pressure on my hips and low back with every contraction. At every 2-3 minutes, he really didn’t get any breaks. Because of the internal monitor, I could not go back in the tub. During this time, the OB noted that the baby seemed to be OP(occiput posterior)/OT (occiput transverse) which explained the back labor and lack of dilation. I needed to hold C’s hand very hard while I was focusing on trying to let contractions happen without letting my body push, even though the baby’s head was pushing against my back and rectum which makes pushing happen. I spent a LOT of this time visualizing my midwife Mary from when I delivered Dee, making me breathe with her instead of letting my body push before I was fully dilated.

The baby’s heartrate was still not doing well with the contractions, so they did a saline infusion via catheter to add some fluid back around her to try to cushion her a bit (I think this was around 9:30). This worked somewhat. The OB on call did mention that if her heart rate continued to be this slow we would be facing an emergency C-section in about 30 minutes; as soon as she said that, Little Cat C’s heart rate sped right back up. While we had expressed our wishes to do this med-free, the nurse could see how much pain I was in and how tense I was, and the fact that I had not dilated any further for two hours despite the frequency and intensity of contractions and my changing positions. She asked if I thought I might want to consider an epidural, just in case that allowed my body to relax and dilate. I immediately went back in my head to J's delivery, and how my decision to get an epidural (evidently) made everything so much worse. Knowing, however, that we already had an internal monitor, and the saline infusion catheter, and I would not be getting out of bed and being able to move around much (due to the interventions plus the SPD). C and I talked about it. He told me I was doing an amazing job and that he would support whatever I wanted; I just wanted to cry because I felt like I was spiraling down the disaster trail I’d been down before. I knew, deep down, that I was completely exhausted and would not have the energy to keep breathing through the urge to push for however many hours it would take me to finish dilating. Around 10:30 I told the nurse I wanted an epidural, though I mentioned my previous experience with them and the source of my reluctance.

The anesthesiologist was amazing and had my epidural in place by 11:00. I could still feel the contractions, but they were 75% less painful and suddenly I found that I could deal with them, breathe through them, and allow my muscles to unclench. I never knew that a properly placed/properly executed epidural could work for me. My blood pressure dropped a lot shortly after the epidural was placed, which I guess sometimes happens. The anesthesiologist came back and gave me a shot of fenylephrine, which fixed things. It did still start to wear off around 3:00, but that was fine with me (that part is coming up). The nurses and doctors noted some meconium in the fluid at around this point, and the baby’s heart rate was still dropping with the contractions even though I was no longer crawling out of my skin with each one. The OB suggested giving me a dose of terbutaline in my IV, to help relax my uterus and give the baby (and me) a break for a little bit. They assured me that it would only be for about 30 minutes, and the contractions would pick back up again (which they did). It worked beautifully, and once I was laying on my right side Little Cat C’s heart rate started cooperating again. I also got to nap for about 2 hours. I was dimly aware of contractions picking back up, and C told me he could tell because I changed my breathing with each one. At around 1:00 or so I woke up and noticed that the contractions were definitely picking up in intensity. I could feel that I needed to poop, and mentioned it to the nurse. She checked me and said that my cervix was softer, and the baby had moved down more, but I was still only at 7cm. The OB said to start pitocin to help the contractions work to move down this OT/OP baby. We did try putting a big peanut ball between my knees to open my pelvis and help the baby turn, but that didn’t really work. The pit definitely did it’s job, and I went back to sleep for a little bit between contractions. My heartrate started going up pretty high, and they noticed I was running a fever (another side effect of the epidural, apparently, because it went away completely a few hours after delivery and I never felt ill at all). I was finally making dilation progress, and actually felt the baby move down during one contraction, but had a very swollen lip of cervix left. They had me try pushing with a contraction to see if they could move it out of the way, but the baby really didn’t tolerate that very well, and it didn’t work. I still kept flashing back to during J’s delivery where I also had a lip of cervix that would just not move. They decided it would be best if I just kept letting the pitocin help (they never had to turn it up very high, I only needed a little bit of a push from it) and we’d check again in a little while.

At around 2:30 I was *FINALLY* at 9cm, but still had the lip of cervix; at about 3 I was complete and started pushing. The OB was absolutely awesome and was able to actually push the little bit of cervix out of the way *and* turn the baby’s head as I pushed (side note: I really should look up who the OB was because I cannot remember her name). If you’ve given birth vaginally before, you are probably familiar with the ring of fire which generally accompanies a baby’s head as it comes out, and it vanishes as soon as the head/shoulders are through I had this VERY mildly with Dee, and very briefly. Well... I had it the entire 45 minutes it took to push Little Cat C and her chubby little body out. I am so, so grateful that the doctor had such strong hands that she was able to turn Little Cat C as she was born. We were unable to delay cord clamping for very long, because she did not cry beyond a couple gurgles when she was born. C cut the cord and the NICU team took the baby over to the warming bed. The OB noted that she was a big baby, probably about 8 pounds. They worked on getting Little Cat C to breathe for what seemed like an eternity. I have no idea what her APGAR scores were. She never cried. I never noticed anything particular about my other babies crying but Cecilia’s lack of crying was awful. I’m getting teary just remembering. I finally asked if she was okay, and they assured me that she was but they were just trying to get her lungs a little more open. The nurses and OBs working on me had me deliver the placenta and did all the usual fun things (no real tears though, surprisingly! Just a teeny little papercut sized thing that didn’t warrant stitching). I did finally get to hold my baby after they did what they so pleasantly termed a “sweep” of my uterus. Yeah. That was horrid. I never again wish to have anyone’s hand inside my uterus, but apparently it was necessary as I was bleeding pretty badly and actually did have clots that were preventing things from properly clamping down. Turns out I had a postpartum hemorrhage, but “only” lost about 750ml (half of what I lost after J was born).

Little Cat C was born at 3:44 pm on January 10, 2015. She weighed 8 pounds, 14 ounces, and was 20 inches long. My reaction to her weight may have been “HOLY GOD, she’s almost 9 pounds?!” She ate for an HOUR after she was handed to me for the first time. Contrary to Dee’s prediction, she never pooped on me. She has so far been very easy and relaxed; having a chubby baby is pretty different! We don’t have to wake her for feedings, and I’ve never brought a baby home that was already too big for newborn clothing items.

Things I have learned? Baby position is VERY important to ease of delivery. My two OP babies both resulted in epidurals, internal monitors, back labor (though J’s was by far worse), and lots and lots of pushing (almost 3 hours with J, 45 minutes with Little Cat C), and longer labors (though Little Cat C's was almost exactly 12 hours, just like Dee, had she *not* been OP/OT it would have been significantly shorter), in addition to postpartum hemorrhages (though this could have been from other things, like the pitocin/epidural/long ass transition) and a bruised tailbone. 

Recovering from the SPD is not really that pleasant. My pelvis doesn't feel properly connected to itself, and I'm just waiting for things to settle a bit more before getting an adjustment which I think will help a lot. I *can* walk pretty well though, which is awesome, and more than I could do before delivery!

Also, epidurals are not the devil. They *can* work perfectly if they are placed perfectly, though I still metabolized the drug faster than normal. Mine did make my face really itchy for a while, which was weird.

A beautiful birth story

I came across this incredible story, linked on Facebook, of a twin mama who birthed her babies naturally at home, where they were born 33 hours apart. There were no complications, and it is a beautiful story.

I know that this is an unusual story, and that there is the potential for a lot of complications and so on, but this story blew me away. I am so blessed to have had my natural experience with my daughter, and it strikes me to the core every time I read another med-free birth story. There is something so primal and so spiritual about the experience, tapping into the ancestry of women through the ages who gave birth without medication (obviously anything more than 150 years ago would be in that category) where Nature takes over.

Beautiful.

(Note to self: you don't want to be pregnant again. Really. Even if you want to give birth again,  you don't want to be pregnant again!)

Baby Dee's Birth Story

Baby girl made her arrival last night (4/27) at 7:44pm. 6 pounds, 7 ounces and 19 3/4" of perfection, with crazy long fingers and a sweet little face.

Quick summary:
Labor started at 7:45ish am on 4/27. Arrived at hospital at 4:45pm, upstairs at L & D at 5. At 7:34 my water broke, and at 7:44 after 3 pushes, Dee was born! I did not have any pain medication or an epidural, and I would not have done it any other way. It made for the most intense half hour of my life, but it was SO worth it.

If you don't want to read the long and graphic version, stop now.

No, really, stop now, unless you want to read about my cervix and mucus and stuff.

Ok, here goes!

I had been just generally uncomfortable on Tuesday 4/26, all day, and my low back had been aching all night. My first contractions that were clearly labor contractions started at about 7:45am on 4/27. We just did our normal thing for a Wednesday, since I was on maternity leave already, so basically C and J went to teach a music class for a local daycare (well, C went to teach, J went to have fun). They came home just about 11, and we went to the library. At that point my contractions were about 7 minutes apart, and while painful/intense didn't really require a whole lot of concentration to get through. While getting dressed right before going to the library I noticed some bloody show, but didn't really think much of it. After the library, we had lunch and watched a movie, and my contractions were closer to 5-6 minutes apart and getting stronger. I took a shower and managed to more or less shave my legs (really, really impressive at pretty much 40 weeks pregnant and in labor...) Each time I went to the bathroom there was an insane amount of mucus, so I knew that my contractions were making me dilate and really lose my plug, as opposed to the past few days where I'd had some mucus but not a lot.

I called my midwives at 3, then called my mom to come get J. We got to the hospital to check in at about 4:30, but didn't actually get checked in until 4:45 because nobody was at the desk We got up to our Labor and Delivery room at 5:00. The nurse we had (for about 5 minutes, due to shift change) was awesome and had observed me through  couple of contractions during the checkin, and said I was doing beautifully. At that point, I was really just making an effort to breathe and relax through the pressure waves, though some were harder to get through than others.

Once up in L&D I had to be on the monitor for 20 minutes. My midwife checked me and I was 4cm, 70%, and -2 station. The waves were still something I could just breathe and relax through, though once I was off the monitor I wanted to be in the bathtub. The nurse told me she'd come back and check on me (as would my midwife) in about an hour and a half, then monitor me some more. This was at about 5:30. By 6:00, in the bath, I was having to vocalize through the waves, and found open sounds like "aaaaaaah" to help the most. About this time I asked C to get me a snack, so I had a granola bar. It was nice, and I was sipping water the whole time as well. Yet another perk to not having an epidural this time...

By about 6:40 I wanted to get out of the tub, and onto the birthing ball. That was heaven. I had noticed some more bloody show when I used the toilet and when I was in the bath, and things were really intensifying. I was starting to shake and having a harder time relaxing, but still able to relax between contractions (this was in the bathtub, still). I noticed my waves were much closer together, but I don't know how close as I wasn't looking at a clock. After a few minutes on the ball, I threw up. I made it through a few more waves and started feeling pushy, and decided that it was time to be checked. I paged the nurse, and everyone came in. I was telling C at this point that I didn't want to do this anymore, and that I couldn't do it.

My midwife checked me, and I was 6cm, 100% effaced, bulging waters, and L was at 0 and definitely in transition. This was at about 7:00/7:15. They put me on the monitor, and gave me oxygen because they noticed that Dee was having some late decels with contractions.They tried to get my IV locks started (2, in case I needed blood quickly, given my history of postpartum hemorrhage) and ended up having to have Anesthesia come do it, because the nurse couldn't get a stick and blew out veins in both hands (very weird, I usually have awesome veins). The anesthesia person came and got my left one done quickly. Contractions were very intense, and very hard to breathe through, and I really think my vocalizations were probably pretty loud at that point. I was desperately trying to breathe with my midwife (also awesome) through the urge to push but it was difficult to say the least. I remember saying again that I didn't want to do it anymore, that I couldn't, etc. At 7:34 my water broke, and there was some meconium present. I could no longer control my body's urge to push, and the anesthesiologist had just gotten my IV finished on my right hand when I started pushing. I was laying on my left side. Within a few minutes, I was complete and pushing with my urges. I felt like I was about to have a bowel movement (I didn't) and then I felt the "ring of fire," which really wasn't that bad compared the the contractions at that point. My midwife looked down and said "hey, we're having a baby" and everyone sort of paused, not expecting that to be so soon. One more push and Dee's head was out, and another after that and the rest of her came slithering out. She was born at 7:44pm, after 12 total hours of labor and the most intense 30 minutes of my life,. No tears, no stitches, nothing! I feel amazing and am very proud of myself.

Oh, and the reason for Dee's decels was that she was all wrapped up in the cord. I did get her on my chest immediately, and she pooped again. Her APGAR scores were 8 and 9.

J's Birth Story

Blogger is really cool in that I can post things in the past! Here is my son's birth story, actually posted 15 months after his birth. How is that for some crazy...

If you don't want to know the details of my son's birth in all their goriness, I suggest you stop reading now. The times are approximate, as C relayed them to me, since I really don't remember much.

Preface: I'd been told I was in "early" labor for about 2 weeks before J actually made his debut. I'd had contractions consistently every 10-15 minutes during that period. I had sort of given up timing them and just finally decided to go with the whole "can't function through one" guideline rather than anything else for when to go to the hospital.

My water broke at 1am Monday morning, January 7. I absolutely felt J just pop his little hand right through the amniotic sac. Interestingly, I did exactly the same thing to my mother when I was finally ready to be born. For about a half hour the amount of water pouring out was really funny to me (I was walking around with a soaked towel between my legs, laughing my butt off) but then the contractions hurt too much for me to feel like laughing. There was some moaning, sitting on the labor ball and vomiting into a clothes hamper, and then we decided I couldn't handle being at home any more. Good times. We got to the hospital (and checked in) at 3am, and I was 3cm and 90% effaced. I spent some time in the tub, which was fantastic and honestly the best pain reliever/relaxer of my entire labor and delivery, and in retrospect I wish I had stayed in there longer. I labored naturally for a while, until my back started hurting too much and I couldn't relax well between contractions anymore. Basically at this point, every contraction felt like someone was stabbing a knife into my colon from the inside. Lovely, right?

By about 6:30 am I was 7cm dilated and decided I really needed an epidural because I just couldn't breathe and relax through and, more importantly, between contractions anymore. The back labor was a huge part of this decision, as was the 3 hours of sleep I'd had. On a scale of 1-10 I would rate my pain at this point at about a 9, and figured I'd better get the epi while I still felt like not dying. I got my epidural around 7am, they had to give me a bag (a bolus, I think they said) of IV fluid first. For the first few hours of the epi I felt great, and wonderful and relaxed. Then about 11am the epidural started to wear off. I first noticed that my back pain was coming back, then that I could feel contractions in my crotch and my butt (oh trust me, the details get much gorier than this). Within an hour it was to the point that I felt the need to push even though I was only 8 1/2 cm dilated so they tried to get my epidural to work some more, with no success. They ended up having to totally redo the epidural (so yes, I got two of them) at about 12. They also started pitocin at this point to make the contractions more useful in helping me dilate. The second time around was nice for a little while but right around 2:30 it started wearing off too.

I was finally 10cm (completely) dilated at 3:10pm (14 hours after labor began in earnest). Pushing is really really hard. I had no idea how hard it would be. We tried a whole variety of positions, the most effective of which ended up being with me flat on my back (which is usually the least effective and worst position to push in). Any other position I tried just sort of reversed what progress I'd made. Finally at 5:15ish (I think, my mind was obviously elsewhere at this point) they paged an OB (not the one I'd seen for ultrasounds, he was out sick) and we talked about the possibility of a forceps delivery (which my mom had with me, too). The doc and I decided that forceps was the best thing to do, and he mentioned that there was an increased chance of tearing, but I said that was fine, just don't give me an episiotomy. He fortunately shared my views on those. Since at that point it was pretty apparent that the baby was facing straight up, the anesthesiology department was called to revamp my epidural (one of my legs was still totally numb, but my crotchal area (is that even a word? Oh well, you know what I mean) did not feel very numb. The extra epidural medicine helped somewhat but holy lord does pushing with forceps hurt. I honestly am surprised I didn't tear more (but we'll get to that later...). Finally after pushing harder than I've ever pushed in my life and hurting more than I thought possible with or without an epidural, J's head finally came out. This part felt like my pelvis was going to break in half, I kid you not. As I've said, he was facing up toward my front rather than toward my spine, which was the cause of my horrible back labor and probably the slowness of my dilation (though I think that the limitations imposed by the epidural, had something to do with it as well). The midwife asked if I wanted to feel his head. I said "No, just get him out." As C put it, his head just kept coming and coming, and when he finally was all out I didn't even get to hold him. They rushed him over to the warmer, where his APGAR scores were 7 and 8- 7 at 1 minute, 8 at 5 after birth. No babies in CO get 10. In the meantime I was being prodded and delivering the placenta (a very very weird feeling by the way). They finally brought J over for me to hold while I was having my 2nd degree tear stitched up. All that and only 1 little tear, and it didn't even hurt as much as I thought it would. Then C took the baby and they started trying to get me to stop bleeding, which had I been more in my senses would have been really scary. C was totally freaked out. After all, if a little blood looks like a lot, a lot of blood looks like you don't have any left. Overall, during pushing and post-delivery, the midwife and nurses and OB were estimating that I lost 1200 ccs of blood (1.2 liters; this is about 1/4 of my total pregnant blood volume). I was very white. I only remember feeling really really weak and that they massaged my uterus which hurt a whole lot (worse than the contractions, I think, because I was so sore and exhausted anyway) and sent blood spraying all over. They gave me Pitocin and a couple other things to make me contract so the bleeding would stop, which eventually worked. By the time they were done the delivery room looked like a murder scene, and my midwife had to go change out of her blood covered scrubs before going to see any other patients and lead the tour of the L&D ward. I finally got to go to the recovery room at about 9pm, meaning it took about 3 hours to get me stable enough to go there. And by the way, in case you were wondering, a Tylenol suppository does not make your ass stop hurting after delivering a baby in the posterior position.

For my recovery I was put on bed rest for 16 hours every day, along with taking copious amounts of iron supplements and iron-rich foods. I think that the iron supplements and their after-effects were seriously the worst part of the recovery process. Hemorrhoids made their first appearance in my life, and my poor perineum was so sore from pushing and being stitched up that the last thing it needed was hemi's on top of that, but alas. Such is life, I suppose.