Wednesday, September 14, 2011

Lewis' Birth Story

Disclaimer: TMI galore! Proceed no further if you are squeamish about childbirth-type gross stuff!

A glad sound

I had a midwife appointment on the Friday when I was just shy of 39 weeks. She checked my cervix and I was dilated 1 cm, which seemed like an encouraging development, although of course not a promise that anything was going to happen immediately. Over the weekend when I was exactly 39 weeks, I lost my mucus plug. This was the first time this rather startling and gross thing had happened to me, as I didn't lose it until I was in active labor with Grace and Violet. Again, sort of encouraging that this baby was getting ready to come, but not a sign that I was going into labor right then or anything.

A few days later, I was awoken around 4am Tuesday morning with contractions that were much more intense and painful than the Braxton Hicks ones I'd been having for weeks and weeks. When I timed them, they were about 10 minutes apart, though, so not really looking like active labor or anything. The contractions stayed pretty much like that for the rest of the morning so Rob went off to work at his normal time, promising to stay glued to his cell phone in case things changed.

That was a weird, weird day. The contractions definitely felt "real"; I had to stop whatever I was doing to cope with each contraction and they were intense enough that I did not think it would be safe for me to drive anywhere. The hours passed, and then passed, and then passed some more, and the contractions just wouldn't get closer together, staying at 8-10 minutes apart for the entire day. I started googling things and decided I was probably in prodromal labor or very slow early labor or, I don't know, whatever you want to call it. The internet informed me that it is not unheard of for this pattern of labor to go on for days (DAYS!). I did my best to rest and conserve my energy and even sleep, with about as much success as you would guess when every 10 minutes my uterus was clenching up in a painful-type manner. I didn't call my midwife until late that afternoon and she was sympathetic and nice but of course couldn't really do anything or tell me anything that I didn't already know. She did recommend that I do everything I could to stop or slow down my contractions and try to get some sleep that night, in the hopes of waking up in active labor in the morning or sometime that night.

That evening I took a warm shower, had a glass of wine, and watched some mindless TV, all in the hopes of calming things down. I felt super-relaxed as I crawled into bed that evening, and then, suddenly, LABOR! Within an hour of getting into bed, the contractions intensified and finally started getting closer together. Eventually they were about 5 minutes apart and at about 1am we decided it was time to go to the hospital. We called our friends who were coming to take care of Grace and Violet to come over (yes, at 1am-- what good friends...) and then drove up to the hospital. THAT was an uncomfortable drive, let me tell you; having a contraction in a moving vehicle is much, much worse than having one elsewhere.

We got all checked in and settled in our labor and delivery room; our nurse eventually checked my cervix around 2am and I was dilated 5cm. Hooray! I was really having a baby! My midwife came and she offered to rupture my membranes. I decided to try walking around for a while first to see how things were progressing on their own, since things would likely get a lot more intense once she broke my water. Rob and I hung out for about an hour, walking loops around the hospital floor, contracting every 5 minutes or so, and eventually laboring on the birthing ball.  We were both quite tired at this point and in between contractions we both couldn't stop yawning; our nurse and midwife laughed at us and our contagious yawns making them yawn too. About 3am, my midwife decided to check me again and OH THE SADNESS, I was still 5cm! I was (and am still) very surprised by this because it felt like I was having good, effective contractions. The first check was with the nurse and the second was with the midwife; I wonder how much these things vary by who is measuring? Anyway, I may quibble but I obviously wasn't making huge progress so my midwife again broached the idea of rupturing my membranes. I decided to go for it, with the idea that I could move into the jacuzzi tub to labor if things really ramped up and got intense and I was having a hard time coping.

The jacuzzi tub was not to be, sadly, because when she ruptured my membranes, both the nurse and midwife made squeamish faces as my amniotic fluid was all full of meconium. I mean, a LOT of meconium. For the uninitiated, meconium is the poop that a baby stores up in his system in utero. They are not supposed to pass it until they are out, and a baby's first few poopy diapers are this stuff, which is all tarry and sticky and weird. When a baby passes meconium while still inside, it means they are stressed to some extent or another and it is a bad thing. For us, it meant that the pediatrics people had to come to check out Lewis right after birth, and that I had to be on constant monitoring until he was born (nooooooo...), and because of that I couldn't get in the tub or walk around or move much anymore. This was particularly unfortunate, because as advertised rupturing my membranes kicked things into high gear pretty much immediately and lots of the labor coping techniques don't really work if you're hooked up to monitors and unable to move.

So there we were, and there we stayed for a while longer as labor progressed. It wasn't pleasant, certainly, and I had a lot of pain particularly in my lower back. I was running out of energy and SO SO tired. Eventually I felt the urge to push and started on the stereotypical scream-y laboring woman routine. My midwife checked me one more time and I was completely dilated so we started pushing. I experienced pushing very differently this time around; with Grace, I had leftovers from the epidural so pushing mainly felt like just very hard work, with Violet, pushing hurt but felt like such a relief after the first part of labor, and this time around it mainly just hurt, especially in my lower back and tailbone. (He sort of spun around while descending through the birth canal from occiput anterior to occiput posterior, or maybe the other way around? I don't remember exactly what the midwife was saying. Whatever it was, it hurt.)

I kind of feel like I did a particularly bad job of pushing effectively this time around. I mean, I don't feel bad about myself or anything, but I'm pretty sure it was my worst showing yet in pushing a baby out. I attribute this to exhaustion; I hadn't really slept in 24 hours at this point and I was just out of every resource I had. I actually passed out briefly a couple time during pushing. I would start to push and the whole room would go starry and black and everybody's voices would fade away for a brief moment before coming back. We kept at it, though, and eventually, FINALLY, despite my inability to really do a good job, Lewis emerged into the world at exactly 5am on August 31. The umbilical cord was wrapped around his neck and his shoulder got quasi-stuck, freaking Rob out for a moment, but he was eventually birthed safely, albeit covered in meconium goo. He wasn't super vigorous when the pediatrics people whisked him to the other side of the room; his first APGAR score was 4, way lower than either of the girls. They intubated him and suctioned him and cleaned him up and generally got him mad and responsive and crying, which in this situation was a good thing. While all that was happening, I delivered the placenta (which my midwife declared to be covered in disgusting green meconium goo-- yeah, thanks for that) and my midwife repaired a small tear I got during the birth. My midwife decided she wanted to give me some pitocin at that point to make sure I didn't hemorrhage (she thought it was a good idea since this was my third birth and I had been in labor for so long) and I said OK, although I think that was kind of silly (AND PAINFUL) since by that point Lewis was back with me and breastfeeding, which releases natural oxytocin that causes uterine contractions anyway. (That's why I make a funny face at 0:57 of Lewis' birth video-- more contractions.)

But oh, it was so, so wonderful to be holding Lewis and to have him safe and sound with us and to be done with the whole ordeal of birth. There is just nothing like the intoxicating newness of a just-born baby who belongs to you, the realization that he is here, that there is this new tiny person to get to know and mother and love.

Some concluding thoughts:
  • I never fail to be amused/horrified by the weird, unexpected "injuries" I end up with after birth. With Grace, I strained an eye muscle so badly that I couldn't focus that eye for a few days, with Violet, I was hoarse for a while from the screaminess, and this time around my tailbone was bruised or something and I burst a ZILLION capillaries on my face, neck, and chest. Seriously, I looked like I was a heavily freckled person. Crazy. Both things were mostly better by the time I left the hospital, but at the beginning my tailbone hurt more than my perineal tear.
  • I was very curious as to why exactly Lewis passed all that meconium and what stressed him. My midwife said it was probably the cord being around his neck combined with being in labor so long. When you have a contraction, the cord gets compressed to some extent, reducing the oxygen that gets to the baby. Apparently the effect here with the cord around his neck was drastic enough to distress poor little Lewis. And he passed ALL the meconium in his system; we changed no meconium diapers at all. He didn't poop at all in the hospital (causing all the nurses to tsk-tsk in a concerned manner), had one sort of transitional poop, and then just went straight to the regular yellow breastmilk poo.
  • At just over 24 hours, this was my longest labor, by a good margin (16 hours with Grace, under 5 hours for Violet). What the heck, man? On my third baby?! I don't think this is how things are supposed to go. Of course, this was also my first time to go into labor spontaneously and have a closer-to-drug-free birth so maybe those are related?
  • This was my second epidural-free birth but I felt pretty different at the end of it than with my first. After Violet's birth, I felt like I'd conquered the world ("I did it!") while after Lewis' birth, I felt more like I'd been hit by a truck ("I made it!"). There were many contributing factors to the difference, but probably the two biggest were 1) the lack of sleep with my labor with Lewis and 2) the artificial speed of my labor with Violet because of the prostaglandin gel I had. Also, the not-ideal positioning (sunny-side-up baby) could not have helped. I also now wonder how much "help" I got with Violet when I threw up. My midwife said that vomiting can really push a baby through the birth canal effectively. I don't know; it just seemed a lot easier last time.
  • Do I wish I'd had an epidural this time, given how rough it was? No, probably not. It was less than 4 hours between when we arrived at the hospital and when Lewis was born so I don't think it would have been worth the hassle of having IV fluids and not being able to walk afterwards and probably a catheter and all that stuff, not to mention the cost. I ponder this now, but at the time it didn't even occur to me that I could ask for one. And anyway, it may have been rough, but he was worth it.
Sleepy boy


Jacki said...

He's precious! great, not-gross, birth story! and, probably will all of the factors going on in that labor, an epidural would have changed a challenging labor/delivery into a c-section (meconium in the amniotic fluid, fetal distress, mal-positioning, slow labor, etc). You made the right choice for sure. Sorry about your tail bone. One of my deliveries broke my tail bone, but I have no idea which one. It wasn't broken 6 years ago, and it broken now but who to blame?? lol! Congratulations again!

Kimberly said...

YAY! I totally hear you on the prodomal labor thing. Although my water broke right at the beginning. 27 hours later I had not progressed past 5cm. He seemed hung up on something. But when I had the C, he was fine. Long cord, not around his neck, no reason for no progression. Sigh.

LOVELY birth story. So happy for you. How was your first day at home with all three by yourself?

Unknown said...

Thanks for posting- you are a super woman! Lewis is precious! Your story sounds very, very similar to my first with Ethan. . .I have been told that boys don't fare as well in labor, lower heart rates, more easily stressed, etc., so that might have played a part too.Enjoy all the variations to come in the wild world of boys :-)

Carlie said...

Wow. Life throws curve-balls, right? Crazy story. Sorry it was so hard! Super interesting to hear all about it though. Thanks so much for sharing. My someday-midwife-mental-files thank you too. :)

Lewis is super gorgeous. That picture is breathtaking.

Eva said...

Thanks for sharing the birth story. Even before Leah was born, I loved hearing birth stories in gory detail. Sorry to hear it was so rough. I think the lack of sleep part matters a lot, and I am in awe of you for not taking the epidural. Looking at beautiful Lewis, one would never guess he had a rough time coming out into the world.

Nikki said...

A beautiful birth story, Julia. I'm so happy for you, Rob, Grace, and Violet. Welcome, baby Lewis!!

I'm not sure if it's because I've given birth as well, but I didn't find any of the birth story to be gross. I wonder if either giving birth or witnessing a birth changes your perspective.

Matthew said...

Julia, I just found your blog. Congratulations on the new baby! I'm glad he's a healthy little guy. Hope life with 3 treats you well -- Shannon and I love the chaos and variety that having 3 kiddos brings to our lives!