Saturday, April 6, 2013

The Arrival of Baby Eilidh

(A planned, natural hospital birth)

I'll begin with a spoiler.  In my sister's words, clearly my labors are of the marathon variety and not the sprint variety. (This birth story is also a bit of a marathon...)

The Warmup

My due date had come and gone... by a lot.  9 days to be exact.  When I went in for an appointment at 40 weeks and 6 days the doctor I saw brought up induction.  Yes, I knew that induction would be a topic once I was beyond 41 weeks, but I really didn't think I would make it that far. I had been having braxton hicks contractions for a few days but I knew it was far from "the real thing." I hit 41 weeks on Thursday and Kirk left the next day for a baseball tournament 2 hours away.  The goal at this point was to not have the baby until he got back (you don't want to attempt a natural birth without your coach!)

On Saturday Kirk got back from the tournament exhausted.  I had been a little cranky all day and no sooner did I storm out of Whit's room completely over trying to put him to bed than I heard a pop and felt my water break (more on this later).  I called my sister and my father, told them the good news and took Kristin's advice to eat and head to bed waiting for the contractions to really kick up.

When Sunday morning rolled around I was having early labor contractions but nothing that ever settled into a pattern.  By noon (more than 12 hours post water breakage) we decided to head to the hospital to get checked out.  I knew I wasn't in active labor yet and I knew that they were going to put me on "the clock" and expect me to have the baby by midnight on Sunday night.  I cried and prayed the entire 20 minute drive to the hospital and worked through a lot of my fears about being forced into an induction and losing my natural birth. At this point I thought it was a complete lost cause.

After several hours at the hospital the verdict was in.  There was no sign of amniotic fluid leaking (apparently your water can re-seal or you can have a forewater leak while keeping the hindwaters intact), my contractions were still far apart and fairly weak and I was only a few centimeters dilated.  So I got to go home with no clock attached and was told to come back when contractions were three to four minutes apart.  Victory!  Natural birth is back on the table!

The First Half (take it slow, pace yourself and stay fueled)

Once we got home on Sunday we grabbed some dinner and I sent everyone to bed.  I was able to get some sleep but things were picking up and every 20-30 minutes a contraction would pull me out of bed so I moved down to the living room to avoid waking up the family and to give me some more space to move around.

Thinking that I was close to active labor, but that it could still be some hours (or days) before the baby was ready to be born, I knew I needed to continue to try to rest as much as possible between contractions.  Thankfully the contractions stayed 15-20 minute apart and some of them were mild enough to sleep through so I managed to get a few hours of shut eye despite being in labor and did my best to snack and stay hydrated. 

When everyone began to stir Monday morning my wonderful mother offered to make me breakfast.  I was perched on the birthing ball doing my yogic breathing while Whit took in some Sprout when breakfast was served.  When I had to stop eating after two bites of toast, I knew "this was it."  Kirk came down the stairs about 20 or 25 minutes later and I shared this bit of information with him.

Since Kirk needed to eat breakfast and I needed something to sustain me since I couldn't bear to eat, we decided to take a trip down the road to the bagel shop and drug store.  Just before getting in the car one of us had the brilliant idea to walk the one mile down the road.  By the time we had picked up my juice from the drug store the contractions had gone up another notch.  To the point that I felt I should stay outside the bagel shop while Kirk picked up his order.   I had two decently strong contractions while Kirk was waiting for his bagel and I was rather impressed with my ability to handle them. This was active labor, this is what I had not experienced with Whit (boy did I miss out!)

It took us about 15 minutes to leisurely walk the mile down to the store.  The walk back was decidedly longer.  After the first quarter mile or so and a few contractions I expressed to Kirk that I wasn't sure I could do this, that I thought I might give in.  He was so supportive telling me that I absolutely could do it and that this is what I really wanted.  Five minutes later the contractions went from every 10 to 15 minutes to every 5 to 7 minutes... mental/emotional roadblocks gone.

When we got back to the house around 10am we sent Whit with Grams to play at Chuck E. Cheese and have some lunch. We knew we would be out of the house before they returned.  I headed upstairs to the privacy of the bedroom while everyone got ready to leave the house and the contractions, while still strong, spaced back out to every 10 to 15 minutes.

30 minutes later Whit came up to tell me goodbye and Kirk came in to check on me.  At this point we thought it would be a good idea to call the doctor and let them know that I was really in labor. When Kirk told the office that I was having contractions 10 minutes apart and it had been happening for about 2 hours, they recommended that we keep our regularly scheduled appointment for that afternoon.  Then they added that we could come an hour earlier if we wanted to and I could be checked in the office instead of going back through triage again (especially as my doctor was the one on call that day).

Just before noon (after about another hour of good contractions) Kirk started loading up the car and I jumped in the shower to see if water really did help ease the intensity of labor.  As with Whit, instead of making me feel better, the shower actually made the contractions more intense and closer together. If Kirk hadn't come in and gotten me out of the shower and dressed I probably would have stayed there for the duration or at least until the hot water ran out.

The Second Half (stay focused and relaxed, keep good form, break it into bite size pieces )


From this point my awareness of the passage of time gets a little fuzzy and the experience begins to resemble a movie script.

It was pouring down rain as Kirk pushed me along to the car.  I hung out in the backseat contracting as he got to the hospital as fast as possible.  When we got to the parking garage I insisted that I could and should walk all the way to the medical building. Kirk did not agree.  He flagged down the patient golf cart/trolly and we sped up to the building.  I did walk down the hall as fast as I could and rode the elevator up to the doctor's office.  At this point contractions were still about 7 minutes apart but from riding in the car or the adrenaline rush from going to the hospital and knowing I was going to have the baby they had kicked up yet another level.  I was still managing everything but I was starting to draw the attention of onlookers as I moaned and squatted through each contraction.

Once we entered the doctor's office it didn't take long for the nurses to quietly say "Let's just get you back to a room..." I went back and they weighed me (!), I used the bathroom and made my way to an exam room.  Suddenly I was at my limit and I felt pushy to boot.  While I tried to breath and relax during the contractions there were a few that I couldn't help but push a little.  After what seemed like an eternity but was likely only about 10 minutes a nurse poked her head in and said "Those contractions sound like they are closer to 4 minutes apart, do you want to go to Labor and Delivery?" I yelled "YES!!" (finally someone realized I was HAVING THE BABY!)

I have to give props to the transfer person.  I never once looked her in the eyes, but she sprinted from the doctor's office to Labor and Delivery.  In the main lobby of the hospital a kind young gentleman gave us his elevator and looked at Kirk with sympathy and said "Good luck man." I have an amazingly clear memory of some of the little things that happened along the way.

In triage someone got me out of my clothing and into a gown (something I don't remember) and then they coerced me onto the bed so that they could check to see how dilated I was.  Although I had refused to be checked for dilation at the end of my pregnancy I needed to know now where I was.  I knew that if I was only 4 or 5 centimeters I was going to give in and get an epidural.  I think it was about this point that I looked at Kirk and said the first of many times "I can't do this!"

I burst into tears when the triage nurse called down the hall "She's at least 8, get her into a delivery room!"  Then she looked at me and said "You want to do this without medications, right?" and I said sarcastically "I don't think I have a choice now."  Natural was the plan, but I was at my limit and so relieved that what I perceived as my limit was actually transition. Back to the wheelchair for a sprint down the hall while I yelled "I need to push! NOW!"  The nurse said "Hold on if you can, the doctor is on his way.  But if he doesn't make it, I'm here. I can do this."

While we waited for the doctor and I tried not to push someone managed to take my blood pressure and get a fetal heart monitor going.  I also scribbled my way through some admission paperwork.  I doubt it took the doctor more than 5 minutes to arrive and he made a wry comment about having chased me all over the UT medical complex.  I was relieved to see that it was the one doctor in the practice that I felt truly comfortable with, the one we had prayed would be on call when the baby came.  I yelled again, "I need to push!" He checked me and said "Go ahead - you are ready!"  (At this point one of the nurses actually asked the doctor if she should try to start an IV.... yeah, go ahead and start an IV on a woman who is actively pushing out a baby...)

I pushed for a few minutes where I was and then the doctor asked me to change positions for the delivery.  Moving was not something I wanted to do at that point, I just wanted the baby OUT, but here I was getting a zero intervention hospital birth, so I flipped over.  I think with every push I looked at Kirk and said "I can't do this!" and he would respond "You can, you are!" Two pushes later and I found out firsthand what the ring of fire is.  "OUCH!" I yelled and I honestly didn't want to push anymore.  I wanted to do anything but feel the ring of fire again.  I got encouragement from many different directions but it was Kirk's "Come on, one more push and our little girl will be here!" that gave me the willpower.  I was able to suck it up and give one more push.  As she was crowning I reached down.  It was beautiful to see my hands and the doctor's hands gently cupping Eilidh's head and guiding her into the world.  It was an image I've seen in many videos and pictures of midwife births, but not something I ever thought I would see ore experience at a hospital.  When her head was out it was impossible not to push one more time to get the rest of her out.

The doctor handed Eilidh to me and I was barely able to wrench my gaze away from her shocked face to look at the nurse and say "Please, don't cut the cord yet." Because we delayed cord cutting the doctor gently ordered that suction also be delayed.  "She's getting enough oxygen from the cord still, she's fine.  Give it a minute and see if the parents want to suction her."  I'm not sure how much time passed because I was locked in a beautiful moment with my brand new baby and her amazing father.  I know it wasn't much longer before the placenta began to deliver (without the aid of a pitocin shot), the cord was cut, and Eilidh greeted us with the only volume level she has...Loud.  She screamed as the doctor and nurses cleaned us all up and continued as loud as she could when she was handed back to me cord clamped and blood wiped away.  The staff quietly exited and I sang to calm the baby as Kirk held on to us both. 

I wish I had a photo of these first few moments but it is locked in my mind forever.  I think Kirk may have captured one on his phone when he sent the text that the baby had arrived just two hours after he sent a text saying we were headed to the hospital.  I feel very blessed to have gotten a beautiful physiologically natural birth in a hospital setting.  I was blessed to be attended by an amazing obstetrician who recently (and fittingly) became the medical director for the midwifery center who handled my prenatal and postnatal care.  I was blessed to have an amazing coach who gave me the inspiration and strength to see it through.  

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