Sunday, February 19, 2006

Grace's Birth Story

Disclaimer: The following contains references to medical procedures, bodily fluids, and general ickiness which may not be appropriate for those squeamish about such things.

Several people have told me that I should be sure to write out the story of Grace’s birth now while the memories are fresh in my mind, so here I go. Hopefully it won’t give our family and friends the heebie jeebies or anything...

Grace was due on February 7 and on February 11, things finally got going. My waters broke about 6am Saturday morning. My OB practice gives you 24 hours after your membranes rupture to go into labor on your own (waiting longer than that increases risks for infections and complications and things), so we went up to the hospital that afternoon just to get checked and to confirm that the amniotic membranes were ruptured. Rob and I spent the day around the house, and although the intermittent contractions I’d been having for weeks did intensify over the course of the day, they were way too far apart to be called labor.

Sunday morning found us at the hospital bright and early, ready to start our induction. They hooked me up to the external fetal heart monitor and contraction monitor (the kind they strap around your belly), along with the IV for the fluids and pitocin. We started out with a teeny tiny dose of pitocin and over the course of the day, slowly increased it. The contractions gradually became more intense; by early afternoon, I was having to really concentrate on coping with the pain of each contraction. The contractions didn’t seem to go through the phases of labor we learned about in our childbirth classes, no doubt because it wasn’t my own body guiding the labor. I haven’t experienced any other labor (obviously) but I would certainly not contradict the people who say that pitocin makes labor more intense and difficult.

By early evening, I wasn’t coping well with the pain and decided to ask for pain relief. They checked the progress of my cervix’s dilation, and I was at 4cm. (They hadn’t checked earlier because of the increased risk of infection from the ruptured membranes.) Since I was that far along, we decided to go with an epidural. Having the epidural placed was a weird experience but I was sure it was the right decision for me in that situation. And talk about a difference! I really am amazed at modern medicine. Once the epidural was in full effect, I could feel each contraction but I perceived them as pressure, not pain. I could still feel and move my legs and abdomen and did not feel at all numb. Unfortunately, I was no longer allowed to get up out of bed because my legs would be too weak. I had found things like the birthing ball and changing positions really helpful earlier in labor, but exchanging those coping mechanisms for the epidural was definitely worth it in this case.

A few hours later, we started to run into some trouble. Grace had been tolerating labor well through the day, but about 12 hours into it, the heart monitor showed that she was not responding well to each contraction. They eventually turned the pitocin totally off to give her time to recover and placed a different, more accurate kind of heart monitor on her (the kind that goes up through the birth canal and attaches to her scalp). With the pitocin off, Grace did much better but unfortunately my contractions became really weak and infrequent. They turned the pitocin back on at the teeny tiny low level where we started the morning, and my next contraction was this really intense long one that caused Grace’s heart rate to plummet. No good, no good at all.

At this stage, it looked we were headed for a C-section-- troubled baby on pitocin, no contractions off pitocin. They checked me again and I was only at 5cm, so there was still a lot of labor to go. Rob and I asked if we could take an hour to see if labor might pick up on its own before we headed into a C-section; the doctor said he didn’t feel comfortable with that much time but would wait 30 minutes. I signed the consent form for the surgery and Rob got his funny OR jumpsuit and we adjusted to the idea of a surgical birth; we were feeling disappointed about it but felt convinced that it was the right decision. In the meantime, the OR got backed up (divine intervention!) and it turned out that we waited about an hour anyway. In this hour, my contractions started up at a respectable rate of every three minutes and Grace looked like she was doing great on the monitors. Rob was watching the monitors saying, “OK, this kid is just messing with our minds now.” The doctor came back in to check me one more time before going into surgery. He found that I’d progressed 1.5cm and since the monitors looked so good, the C-section was put on hold. Hooray!

In another hour I was fully dilated and Grace continued to do well. My epidural had started to wear off, which is what they intend so that you can feel to push effectively, so I was experiencing pain again but not nearly as badly as on the pitocin pre-epidural. We pushed for 2 hours; it was really hard work and hurt but in a different way than the contractions. It was exhausting, actually, and near the end I was really starting to run out of energy to push effectively. We ran into another little hurdle as I struggled to finish pushing, and the OB suggested an episiotomy. I said I would try a few more pushes on my own but when those didn’t work, I happily acquiesced to a medium episiotomy. Grace came out quickly after that, and was born at 2:24am on Monday, February 13.

I had a fever by the end of labor which could indicate an infection so Grace had to be checked out immediately after birth by the pediatricians (and I had to have a bunch of IV antibiotics). She looked great (which you can see for yourself in the video) and they brought her back to me as I was being stitched up and put back together. Rob bringing her over to me and holding her for the first time was, as cliched as it may be, a fundamentally life-altering and wonderful moment.

Things that surprised me about labor
  • Ahead of time, Rob and I did not have a specific agenda for labor but thought that we wanted to minimize interventions, stay at home for a long time during early labor, maybe avoid pain medications, etc. This is definitely not what happened, so that was a surprise.
  • I am surprised by how little this fact bothered me at the time, or bothers me now. The fact that we have our daughter safe and sound really is what matters, just like they tell you.
  • I am surprised how great an epidural is.
  • I am surprised how little the annoying requirements of getting an epidural (catheter, only ice chips, no getting out of bed) bothered me.
  • I am surprised I ended up with an episiotomy. I was all for just letting nature take its course and tearing a bit if necessary. I just didn’t have the energy at that point, so another preconceived notion out the window!
  • I was really surprised by a couple of the effects of our long pushing stage; my face was super puffy for a couple of days and I strained an eye muscle so badly that I couldn’t focus my eyes for about a day.

To sum up this very long account, I’ll just say that the rest of our hospital stay was smooth and uneventful. Both Grace and I did splendidly and the three of us are glad that the experience of labor had such a wonderful outcome and that we are enjoying being a family now.

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