February 7, 2013

Evan's Birth Story

By the time I was 41 weeks pregnant, on Wednesday, January 16, I knew I had less than a week left of being pregnant. The midwife I saw for my prenatal care was absolutely fine with me being pregnant past 41 weeks, but it's their policy to induce labor before 42 weeks. I had an appointment with my midwife, Carrie, on Friday morning (January 18), and we scheduled an induction for the following Tuesday. In an attempt to avoid a medical induction, I decided to have Carrie sweep my membranes. She told me there was about a 1 in 8 chance it would actually put me into labor, and it could cause some pain. At this point I was willing to give it a try. I had read quite a bit about membrane sweeping online and read several accounts saying it did nothing, but many of these women were around 37 weeks pregnant and 1 cm dilated, and none were 41+ weeks pregnant and 3 cm dilated like I was.

Not knowing how I would feel after the procedure, I had taken a vacation day on Friday. I ended up not being in much pain at all, just discomfort similar to mild menstrual cramps, but I was glad I had the rest of the day off. I put a pot roast in the crock pot for dinner, ate lunch, and slept for a couple hours. I tried doing some acupressure on pressure points supposed to induce labor, but I think all that accomplished was giving me a headache. Nathan came home from work, and we took the pot roast over to friends' house, played a game, and got back home close to midnight.

I woke up at 4:00 Saturday morning. This was the fourth night in a row I'd had little sleep. Fortunately I was able to sleep off and on from 6:00 to 8:00. During this time, I started feeling cramps. I thought the symptoms of having the membrane sweep had just taken until the next morning to set in. The strange thing was, I would feel cramping for about a half a minute, then it would stop for a while. The pattern seemed like contractions, but the sensation was only in one spot. Around 8:20 I told Nathan what I was feeling and started looking at the clock when I felt the cramps. Once I realized they were coming every 5-7 minutes, I used my contraction timer app to time them and found they were lasting about 30 seconds. I was convinced at this point they were actually contractions, even though they didn't feel like what I had experienced at 22weeks. As I was lying in bed, I told Nathan I needed breakfast, but didn't know what I could eat. He knew I was in labor when I told him oatmeal didn't even sound good. I decided I could handle a smoothie. Around 9:00, I gave up on sleeping and got in the shower for some relief. Nathan called our doula, Ana, to let her know I was having contractions and started dog-proofing the house enough for us to be able to leave the dogs for two days (They have a dog door and we had someone stop by to feed them). I got out of the shower and worked on grabbing a few last minute things for the hospital bag. Nathan asked me what I wanted in my smoothie, but by that point I couldn't eat at all, so he then finished packing our bags for the hospital.

At 9:26 I got a call from the HR coordinator at work, who was using her Saturday morning to work on paperwork and wanted to know if I was going to be back at work on Monday. "Well, I'm having contractions every 7 minutes, but labor could stop..." I confirmed everything was good with my paperwork and then went back to having a baby.

My parents, brother, and grandpa had been planning on coming over that day to go out to lunch and bring me my birthday gifts and cake since it had been my birthday the previous Monday. Of course we knew that plan could change, but after being pregnant 41 weeks, I had basically decided I might as well live my life as if I'm never going to go into labor. I called my mom and told her she should hold off on coming since I was in labor and didn't feel like eating cake, or anything else at the moment.



By 10:00 I was having contractions every 3-5 minutes, but they were only lasting 30-45 seconds. I decided we should take the opportunity to get one last maternity photo at 41 weeks. After that, I went into the living room and tried to get comfortable. I had Nathan put on The Lion, the Witch, and the Wardrobe for me. Everything I had read about early labor said the best thing to do is distract yourself from the contractions. I started crying two different times while watching the beginning of the movie, and I have no idea why. Crazy hormones. About 40 minutes into the movie, it was clear distraction was no longer working. Nathan and I couldn't find any positions that made me more comfortable. I told Nathan I felt like I might get sick, and he brought me a trash can.

Nathan and Ana started texting back and forth about how things were going, starting at 11:08. I told him to ask her how far I had to progress before she would come, and she suggested we check back in at noon and see how I was doing. At 11:27 I told him to just call her. My contractions were 2-3 minutes apart by this point and 1 minute long, but they hadn't been a minute long for over an hour like they're supposed to be before you go to the hospital. After I finished a contraction, Nathan started to give me the phone, but I began throwing up. Ana realized then just how quickly things were moving and told Nathan she needed to meet us at the hospital instead of going to our house. Ana called the hospital to let them know we were coming. I thought it was still too soon to go to the hospital. After all, I didn't meet the rule of contractions that were 1 minute long for over an hour yet. Nathan said we had hired a doula for a reason and we needed to trust her instincts. I was still worried we might be sent home, but I didn't argue. I went almost 10 minutes without having a contraction on the drive there, which really made me worry my labor wasn't as far along as we thought.

It was about 12:15 when we got to the hospital. The walk from the parking garage to labor and delivery triage was a long one, but I knew walking would be better during labor than sitting in a wheel chair. Ana met us at the front entrance of the hospital. As we walked past the front desk, a man asked, "Do we need a wheelchair here?" Ana told him that no, actually, walking worked to our advantage. Confused, he basically insisted we needed a wheelchair for the long walk. "Yes, we know how long it is." A little farther down the hall, I saw one of the pastors from the church we've been going to. That was kind of random. Nathan talked to him for a minute while I had another contraction.

When we got up to labor and delivery triage, Ana completely took charge. Knowing about our bad experience in triage earlier in my pregnancy, she wanted to make sure we spent as little time there as possible. She told the lady out front that she knew they had to ask questions about domestic violence, but this was a safe situation, and Nathan was let in with no protest. I started having another contraction, and by the time I'd finished, Ana had already given the person in triage my insurance card and driver's license. I was amazed she had found them that quickly in the mess of my purse. Ana talked to a triage nurse about how we'd had a bad experience in triage before. I went to a bed and was hooked up to the monitor. One of the midwives, Cheryl came in. She had been the midwife in triage the last time I was there (but had nothing to do with why I had a bad experience). As soon as she opened the curtain, she said, "I do remember you! Miss I have a huge fibroid inside me!" Cheryl checked me and said I was at 6.5 cm dilated. Wow. I was pleasantly surprised! "You're not going home!" Ana told me. Knowing I was farther into labor than I expected and with the trip to the hospital behind me, I was feeling pretty good at this point. We waited in triage awhile longer while they got the room ready. I didn't know if I wanted a water birth, or if it would even be possible, but I wanted to have a room with a tub so I could give it a try at least. We were probably in triage for less than an hour. I didn't have to get an IV or even put on a hospital gown.



I got into the tub almost immediately after getting to my labor room. I remembered my friend Amber saying she'd felt almost normal after getting into the tub for her water birth, and I could see what she was talking about. The warmth was relaxing, and the buoyancy of the water meant I could float around in all kinds of positions for relief. For about two and a half hours, I could manage the contractions really well, and in between I was just chatting with Nathan and Ana. Nathan started eating the trail mix I'd packed. Neither of us had had anything to eat that day. I asked if he would give me an almond, and he gave me two. Not long after that, I said, "I'm probably going to be throwing up soon" and I was right. Eating during labor, although permitted at our hospital, was not a good idea for me.


Things got a little tougher around 3:00. I could still handle the contractions, but I asked Nathan when he was getting into the tub, and he put on his swim trunks and joined me. I had just reached the point where I wanted him right next to me. The contractions got more and more intense, and the time between them became shorter. At times I had almost no break in between. I started getting vocal with the contractions, not crazy screaming or shouting out profanities, just making sounds. I hadn't expected to be quite so loud during labor, and neither had Nathan, but it seemed to help work through the contractions, and Ana was encouraging me to do so. At one point Ana told me I was well into transition, which surprised me. Transition was supposed to be the worst part of labor, when women say "I can't do this." I never once said or even thought that I couldn't do it, although during a couple contractions I did wonder why I was having a natural birth. But then I'd finish the contraction and be at peace for a few seconds and know I could get through it. The midwife, Jill, did another cervical check around 3:30 (yes, while still in the water). She discovered the bag of water was bulging out and suggested breaking it to help labor progress. Some meconium came out in the water when she did so, which meant NICU would have to come in when the baby was born to make sure he hadn’t inhaled any. I wasn't told how dilated I was and didn't ask, for fear of being disappointed. Because of this, I was a little shocked when I said, "I feel like I need to push!" and received responses of "That's okay!" Really? I had heard about women getting the urge to push before they're fully dilated and having to hold back, so I was worried it wasn't time yet.



We could see the head by 5:00. A mirror was brought over so I could see that amazing, bizarre sight. With Nathan holding me, the baby started crowning. The end was near...except that it wasn't. I pushed through contraction after contraction and got nowhere. We still could only see the very tip of his head. Jill, Ana and the two nurses surrounded the tub, waiting for the baby to emerge, but he didn't. Everyone was suggesting different positions to try. We ended up with three videos on our camera of what was supposed to be the birth of our son but wasn't. They were carefully monitoring his heart rate through this (with a wireless monitor held onto my abdomen), and it stayed in the 120's.

Around 6:00, Jill told me I needed to get out of the tub so we could try other positions to get me more leverage. If you're wondering how one climbs out of a labor tub with a head sticking out of them, well, so was I. They moved the bed closer so I only had a few steps and supported me, but wow was that rough. We tried different positions on the bed, including pulling on a sheet tied to a squatting bar. That head still just was not budging. It wasn't due to lack of trying, from me or the baby. At one point he started rotating his head from side to side. Thinking the difficulty getting the head out could mean a huge baby and difficulty getting the shoulders out, they brought in an obstetrician, who happened to be the head of all the obstetricians of the hospital. After trying some more positions, the doctor felt around the baby's head and recommended doing an episiotomy. When Jill told me this, all I could do in response was moan. I'm not sure what all was discussed. I could hear Nathan talking to Ana about it. Knowing that episiotomies can lead to more tearing and it's better to tear naturally, I definitely didn't like the idea, but I just wasn't tearing on my own. I knew they wouldn't be suggesting it unless they thought it was truly needed. I remember asking how much it would hurt. I don't really remember giving consent but must have. I didn't feel any pain from the episiotomy, just pressure. As soon as it was cut, I pushed one more time and felt my son being born. Not just his head, all of him! Now that was a crazy feeling! At 6:38, he was finally here. Jill unwrapped the cord, which was around his neck three times, and handed him to me.


Evan gave a little cry when he first came out, then was content on my chest, eyes wide open. I was so focused on him that when I delivered the placenta I thought, "Oh yeah! Afterbirth. Forgot all about that." The initial skin-to-skin bonding time didn't go quite as well as I'd hoped. Having a second degree tear assessed and stitched up while my uterus was being forcefully pressed on was just not conducive to bonding with my baby. Of course, it was still good for Evan. He seemed oblivious to what I was feeling and was eager to start nursing.



When I found out Evan was only 7 lbs. 11 oz., I was a little surprised. I would have thought after 41 weeks and 3 days gestation and with the trouble we had getting him out, he would be a little bigger. Then we found out he was 21.25 in. long. Apparently he just got longer during his extended stay in the womb, not heavier.



Although the last hour of labor was physically and emotionally draining, overall my labor and birth experience could not have been any better. A high risk for c-section birth that almost ended up being a water birth? I was extremely blessed. My fibroid never shrank smaller than 8cm, and with the way things looked at my ultrasound at 35 weeks, I had no idea how that baby was going to get out without a c-section. I still don't know how, but I know God is gracious, which is Evan's meaning in Welsh.



I had an awesome support team for my labor and birth. Nathan was amazing throughout my labor. I knew he would be great at supporting me emotionally, but I had no idea how much he would end up physically supporting me through labor. When I was pushing in the tub, he was grabbing my legs and pulling them back to my chest, almost as if we were pushing the baby out together. Having Ana there for extra support and a smoother experience at the hospital was invaluable. She spoke words of encouragement to me throughout my labor, fed me ice chips, and even made sure to put in our food order before she left. I'm sure she did more than I even realize, and I know having her there made Nathan much more at ease. We will be using a doula next time for sure. The midwife, doctor, and nurses I had were outstanding, and I never doubted that they had Evan's and my best interests in mind.



Most importantly, my birth story ends with a healthy baby. Despite passing meconium, getting stuck crowning, and having the cord around his neck three times, Evan was perfectly fine. He is thriving in the outside world, and I love being his mother. I don’t even mind that he decided to interrupt my birthday party with his own birth. I think having birthdays the same week is pretty special. I'm looking forward to this journey of motherhood.






3 comments:

  1. Aw, congrats!! I'm so glad to hear how smooth his birth was, aside from the episiotomy. That gives me hope for my own, as we're also hoping for a natural birth. We also hired a doula, so hopefully that'll help. So happy for you and baby Evan. Enjoy being a mama!!

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    1. Thanks, Carmen! For me, getting stitched up was worse than the labor (even with a shot to numb me), so hopefully you won't have to go through that. Glad you hired a doula!

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  2. What a sweet story Amanda! So glad you were able to have him without a c-section, and he is so cute! You're lucky you didn't have a rough delivery of the placenta - it was pretty painful for me, no fun!

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