Wednesday, June 23, 2010

A Baby Story

Alice was due on 5/9, she was born 11 days "late" on 5/20. Many of the doctors involved in our prenatal care wanted to induce labor at 41 weeks exactly. We had to circumvent the doctor we'd been seeing at the end of the pregnancy in order to get even a few days extension. He'd wanted me to sign "against medical advice" if I waited even a day past 41 weeks to induce. Knowing that many first babies come late (one study puts them 8 days late on average), I wasn't comfortable with medical intervention unless absolutely necessary and definitely wasn't comfortable with signing against medical advice when arbitrary 41-week induction is relatively controversial. Many doctors worry about the slightly increased risk of still birth due to cord accidents or aging placentas after 40 weeks but statistically, you'd have to induce 1,000 women to save about 4-8 babies. Based on my reading and research into modern medical childbirth practices, I felt like there was a much higher likelihood of negative outcome (known and unknown) from using Pitocin to induce labor, as well as the potential for a "cascade of interventions," especially since still birth and cord accidents are a risk throughout one's entire pregnancy.

Anyway, long story short, we were only able to fend of the induction enthusiasts until about 3 days past 41 weeks and then the perinatologist recommended inducing within 2 days, especially since I was still only 1cm dilated. Already worn down from weeks of anxiety about the issue, and from about three weeks of anticipating (and hoping) that labor could start at literally any second, we finally gave in. We scheduled an appointment for induction at 6pm the following day, giving us as much time as the perinatologist felt comfortable with to try and get labor started naturally.

We'd been walking along the stretch of path near our house with increasing frequency over the two weeks before that, and now we really stepped up our efforts. We walked as often as possible, for as long as I could handle. My poor feet, ankles, knees, hips, and back were killing me, but I'd never before wished for even more pain. I had only started noticing Braxton-Hicks contractions the day before my due date, and they would pick up a little when we went for walks. I felt them as mild cramping in my lower back, not at all what I expected contractions to be like. My belly would gradually tighten as we walked, so it was rock hard by the time we finished, but I didn't feel it tense and relax like I expected. I certainly couldn't time these contractions, and they weren't happening with any regularity or increasing frequency. Once I was relaxing on the couch at home, they would stop almost entirely.

By the way, walking wasn't the only labor-inducing method we experimented with. I tried literally every home remedy to encourage labor; spicy food, THE famed salad dressing at a local pizza place, castor oil, accupressure, massage, SO much walking, and a few more risque techniques that I won't elaborate on here. I think it's safe to say that none of them helped, even a little.

Despite all our walking that day and the next, nothing seemed to change. On the day of our induction appointment (5/19), we spent a quiet day at home, hanging out with our kitties in between walks, knowing that our regular routine was about to change forever. I was pretty upset about the imminent induction, but I was trying to focus on being excited on the outcome instead. We were trying to wrap our head around the fact that we'd actually be having this baby! Finally we passed the point of no return; labor was obviously not going to start spontaneously, and I had to get ready to go to the hospital. I blow-dried my hair and put on makeup (something I hadn't done in weeks!) and put on a nice dress. I felt a little silly about it, but it helped boost my spirits and helped me to start the night feeling my best. What I really should have done was sleep from noon-5pm, I don’t know what I was thinking...

My mom and sister brought some food to our house and we had a "last meal" from CPK. At 5:30, we set off in a caravan for the hospital; Jon & I in one car and my mom & sister behind us. Jon's parents were to arrive shortly after we got to the hospital, having hit some traffic on their way up from Orange County. It was so strange to drive to the hospital and not be in labor. It wasn't at all like what we've come to expect from TV and movies.

Once we were all checked in and settled into room #2, we talked over the options with the midwife. I wanted to try a low dose of Pitocin for as short a time as possible to see if that would encourage my body to take over. The midwife was not encouraging, but said we could try it overnight and see what happened. The nurse started the IV with saline and went to get the Pitocin, leaving me connected to the monitors while she took care of some things. Before they could get the Pitocin in, the midwife came back within about a half hour and said it looked like contractions were picking up and I might be starting labor on my own. I got the go ahead to walk the halls and see if I could help move things along. Jon & I paced the hall for a while, stopping every few minutes for a contraction, before heading back to the room. We hung out with our family for a while, pausing for contractions, before things started to get serious. The next few hours passed in a blur of pain and pauses. Coming out of each contraction felt like coming out of a trance or a deep sleep. Although the contractions were intense and very close together, I wasn't progressing super fast. The midwife was estimating that I'd be fully dilated by 7 or 8am, and ready to push by 9 or 10am.

By about 1:30am, I felt like I'd reached my maximum pain tolerance and was losing control during contractions. It might have helped to have taken a birthing method class, or to have had a doula to coach me through, but it's hard to say. They wanted me to stay connected to the monitors so even though I was allowed to move around, there is only so far you can go when you're tethered by an IV pole, two belly monitors, and a pulse/oxygen monitor. I didn't have much time between contractions to try to find a comfortable position, while wrangling cords, and the fetal monitors would fall out of place every time I moved. I ended up laying in bed, which probably wasn't the most comfortable or productive position. Anyway, by about 1:30, I decided I couldn't take another 5 or 6 hours of contractions and increasing pain, let alone the grand finale. Everyone tried to convince me that I could do it without an epidural, like I had wanted, but I knew I needed it at this point.

I had been pretty scared of the epidural procedure, and it didn't help that they made everyone leave the room. The anesthesiologist paused his work during contractions but cautioned that I would have to be absolutely still if I had a contraction while the epidural needle was in place. Of course that happened, since the contractions were so close together. I knew he wouldn't be able to get it done in between contractions! He was awesome though, and I was able to hold still. After he tested the meds to make sure all was as it should be, he asked if I'd felt the last two contractions. Barely, I told him, and didn't feel the next one at all. Jon said when he left the room, I was in the worst pain he'd ever seen. When he was able to come back, I was almost asleep, grinning and giving the thumbs up while the contractions continued their job, unnoticed by me...

I was all fixed up by 3am and was able to sleep until about 6am. Jon's parents took a nap in their van, while Jon, my mom & sister took turns napping and babysitting me. The sun came up, the staff’s shift changed, and it looked like everything was still on track. We were just waiting for the baby to descend as low as possible and for the urge to push to become stronger and constant. Around 10:30-ish, we decided to give pushing a try. Things were looking good, but after about 20 minutes, the contractions had spaced out too far to do the job properly. They fixed me up with some Pitocin and we were finally looking at the final stretch!

I was expecting to push for around 2 hours and was super happy when it turned out to be less than an hour. I was also super happy about the epidural at that point - pushing was easier than I expected, but it wasn't entirely pain-free! We were the only people checked into the whole unit that morning, so instead of just a nurse and midwife delivering the baby like we had planned, everyone on the clock ended up in our room. I think the final total was 8 of them (OB, resident, midwife, nurse, nursing student, her supervisor, neonatal nurse, and an equipment nurse), plus our moms, my sister, Jon, me & the baby makes 14! I didn't even know the OB was in the room until he remarked that "You Can Call Me Al" was playing on the iPod while Alice was born. That has been one of my all-time favorite songs since I was like 4 years old, and obviously relevant to Alice now (but please DON’T call her ‘Al’)! There was all the obvious tears and joy when we finally heard those newborn cries - even the nursing student cried (it was her first birth). We were so relieved to finally meet our healthy, perfect baby after all our anxiety and waiting!


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