Sugarbeet's Arrival - Part 2

As with part 1 - here is a link to some cute elephants if you aren't up for or into a birth story post :). - Cute elephants click here.

So, once we returned from a week at the beach and I scrubbed my kitchen until it looked brand new, stocked my freezer with food, and had my car cleaned and then re-cleaned it until it looked new, I figured Sugarbeet would be arriving soon.

I never reached the point in pregnancy where I was just done and wanted baby to just be out. Probably because I went into labor at 34 weeks, 5 days and I had believed all I had read about first babies always coming late. I had seen my midwife 2 days prior and while things were definitely changing - period-type cramping, baby had dropped, I felt different, etc - I knew that it could still be weeks and wasn't getting my hopes up too much.

We had a birth plan, but the one thing I have picked up on in my not-reading-birth-stories-experience is that birth plans rarely go exactly as planned and so we had listed our preferences but were very aware that it could change. As I heard the other morning, the one missing variable in any birth plan is your actual labor. Our general plan was to labor at home as long as possible, to not have any medicines/pain killers, to have immediate skin-to-skin care, to nurse immediately, and to not be separated from baby at any point.

On Wednesday, Aug. 5, around noon, I noticed some leaking and wondered if maybe my water had broken, but when the leaking seemed to stop I figured it was either a mucus plug breakdown or urine. As the day progressed these leaks came and went and finally after dinner I figured I'd better call the midwife before we settled in to watch a movie just to be sure, because I was GBS positive, and knew that my water breaking was one reason I'd have to go to the hospital earlier in labor rather than later.

So, midwife said come in and when she did the little ph-strip test, it turned blue immediately and she said 'you'll be staying.' Good thing R had insisted on taking our bags :).

I then had to have my first cervix check - which was awful. Short midwife with short fingers + tall patient who is not dilated at all = OUCH! Yea, I knew right away I did not want to have many more of those and fortunately being GBS+ with a broken water meant they wanted to minimize checks as well. Because I was GBS+, I was put on penicillin and received it through IV every 4 hours. And that was my second OUCH! That stuff stings hurts like heck hell (sorry, it's the truth) going in - thank goodness for ice packs!

We were given some options to get labor going because the ideal is to deliver within 24 hours of your water breaking and since I didn't know for sure and hemmed and hawed all day long, we were already about 10 hours behind schedule.

We opted for cervidil to ripen my cervix and the plan was to insert that and get some sleep. Because I was on the cervidil, instead of the periodic fetal heart-rate monitoring we wanted, it had to be monitored constantly. So, just as I settled in after getting my penicillin and monitors set (Sugarbeet wiggled a lot and kept moving away from the monitor), the lights were dim and we were both getting ready to sleep, the nurse came in and said I needed to move to my side immediately - Sugarbeet's heart rate had been slower than they like to see. That didn't work as they hoped and suddenly the lights were on, the room was full of people and before I even fully realized it, the cervidil was being taken out. It all happened so fast and seemed so out of my control, and even the midwife's control for a moment. The resident that came in to oversee, was kind, but I preferred my midwife. She asked some questions of the nurses, Sugarbeet's heart rate came back up and she expressed that she didn't think it was the cervidil and would check with the attending OB and be back.

About an hour later she came back, OB agreed they didn't think it was the cervidil at all that impacted the heartbeat, rather that baby had just been moved away from monitor and I was more on my back than usual. So, everyone was OK with trying the cervidil again. It was reinserted at 6:00am and could stay in for 12 hours. Our quiet night's sleep was no more and we were getting closer to the 24 hour mark.

Also in all of this, my blood pressure was creeping up. Bloodwork was all normal and the thought of a catheter to get a direct urine sample to check for protein (to rule out preeclampsia) was not something I was interested in having done, and so we opted for a wait and see approach.

At 7:00am on Thursday, Aug. 6, we had a midwife switch (the practice I go to has 9 midwives). The new midwife was a little more concerned about the 24-hour mark than the first one, but she was willing to wait and see a bit longer. As noon came and went, we talked about other options to get labor to progress more, none of which were at all something I wanted to do (um, foley-bulb, no thank you) and since my temperature was normal, baby's heartrate was good, and my blood pressure was high, but not too high, we decided to wait until the cervidil had to come out at 6pm.

At 3pm, things changed when the cervidil came out on its own. I consented to another check at this point to know if it was doing anything. I was 1cm dilated and 30% effaced. Nothing to get excited about, but enough to start pitocin and have it be able to work. I had been having some very mild contractions, but nothing that was worth getting excited about. We had taken all sorts of laps around the labor and delivery unit and were more than ready to get things moving (plus, we were hoping for a Transfiguration baby :).).

Just before the pitocin, it was time for penicillin again and my IV was really hurting, even with a saline flush. They determined it was infiltrated and we started to look for a second IV location. My nurse was wonderful and said she recommended in the inside of my forearm, but was honest and said she couldn't get it in there. So, we called the IV lady to do it. When she walked in, I breathed a sigh of relief because anyone who can wear white scrubs and start IVs all day without a drop of blood on her has got to be good, right? And she was - new IV in forearm went in without problems and felt better immediately.

So, finally, at about 4:30 or 5, the pitocin was started. I was nervous because I'd heard all the horror stories, and confirmed that we'd start with a very low dose. Soon after it started, the contractions began to intensify and for the next 6 hours, I had what seemed to be very productive contractions, getting stronger and closer together. The only way that I was comfortable during contractions was standing up, holding R's hands, and leaning into his chest. I'd then sit down between them. I tried the birthing ball, squating, leaning forward, sitting up higher, nothing that involved any pressure on my lower back during a contraction worked. And so I sat and stood for those hours. By 10pm, I was exhausted. My legs were shaking, and it was getting harder and harder to stand up for each contraction. I was feeling positive because the contractions had been so close together and intense for so long, that I agreed to another check. (Oh, and we were on midwife and nurse #3 because there was another shift change at 7pm.)

I was only 4 cm dilated and 50% effaced and suddenly I was the lady on the birthing class video who I swore I would not be and I was crying because I had not progressed as much as I'd expected. And my exhaustion became overwhelming. I knew I needed to rest somehow, I was over 24 hours in the hospital at this point and had barely slept on top of the standing-up laboring. While the contractions were painful, as long as I was standing and breathing through them, I was doing ok. But, the exhaustion was becoming more than I could take - mentally and physically.

We asked the midwife and nurse what our options for the exhaustion were, and we all agreed that we weren't ready to jump to an epidural, so a narcotic analgesic would be a good in-between step. It would be in my system about an hour, giving me an opportunity to rest, and hopefully my relaxed body would respond well and I'd progress a bit more too.

I got the stadol sometime between 11:00pm and midnight. For the first half-hour, I got the rest I so desperately needed, I could still feel the contractions and could tell they were intensifying, but didn't care much about them. Sometime at the mid-hour point things started to change, not only were the contractions getting much more intense and I was starting to care, but in between contractions I was having the most awful dreams about baby parts and the pla.nn.ed paren.t.hood videos that were being released in the days just before. So, no longer was I getting a mental break and the physical break was less and less as well.

As the hour came to an end, I was in a lot of pain with each contraction, was scared to death to be checked again because 1) it hurt and 2) it had only been an hour and I didn't want to be told that I was only 5 or 6 cm dilated. But, I also knew that I could no longer breath through these contractions. I couldn't really articulate it at the time, but they were different and it was just literally holding onto the sides of the bed to get through each one. A dear friend had once told me "childbirth is supposed to be painful, but it should not be suffering. If suffering starts, get an epidural." That simple distinction of pain vs suffering had really helped me to this point and now I was sure that breathing through these contractions meant suffering. And so, R and I started the conversation about an epidural. He knew it was not what I wanted to do, but also heard what I was saying about suffering, and so, with some disappointment from both of us, we told our wonderful nurse, G, that we wanted the epidural. Then, I said I needed to go to the bathroom, or something. It felt like I wanted to push or go to the bathroom - and I knew this was a sign of labor progressing, but didn't believe I could be actually ready to push. I remember feeling very confused, disappointed that I was getting an epidural, and a weird combination of being panicked and not caring at all that I was going to poo and pee all in the bed.

This description to G gave her all the information she needed and she gently said, why don't you let the midwife check you one more time before the epidural, just to see. And for whatever reason, I did.

As the midwife did the check, I admit to feeling a little defeated, exhausted, and scared about what was to come next. But, the check didn't hurt, not at all, not like before; and she look up and smiled and said "you are 10cm and fully effaced" and I immediately replied "so I can push then?". To which she replied, "Yes!".

And just like that, it was as if someone had flipped a switch and my defeated feeling of not being able to do it and needing the epidural to stop the suffering was immediately gone and I was determined and ready to push. Again, I couldn't have described it this way at the time, but I knew I couldn't just breathe through those contractions, that it was suffering to do so, but if I could do something productive with them, like push, well, then, let's do it!

And so, at 2:05 am I started to push. And I laughed internally because I remembered our birthing class and how lying in the bed on your back pushing is the worst position because you get no help from gravity, but there I was laying in the bed on my back, pushing. And I knew, instinctively somehow, that was where I needed to be - but, I did happen to bump the bed adjust button with my elbow during one push and it inclined the bed just enough that I could really tell a difference.

And for 2 hours I pushed, with Sugarbeet crowning for at least 2/3 of those 2 hours. I had no sense of time during those 2 hours - they could have been 20 minutes, 2 days, or the 2 hours they were - I didn't feel like they dragged on, and though it was hard work, I felt very productive throughout.

And finally, at 4:06 am, Sugarbeet was born. I got a little impatient with R asking if it was a boy or girl, but as he explained later, there's a lot going on there and he wanted to get it right! And finally (it was mere seconds) he told me Sugarbeet was a girl. I got to hold her for a few seconds and then she was taken to the warming area. The NICU pediatricians were standing by because I was GBS+ and my water had been broken for so long. We knew this would happen, and in those moments, while R stood with her and took photos, I prayed that she was OK and would be brought back to me instead of being whisked away. And she was. She was brought back and placed on my chest. R had been able to cut her cord, and she passed her apgars and was perfectly healthy.

We were moved upstairs to our recovery room and home for the next couple of days. She nursed without any problems right away and had even started to gain weight back before we were discharged - she was born at 6 lbs 15 oz, dropped to 6 lbs 8 oz, and was 6 lbs, 10 oz at discharge.

While we had a long list of preferences, the most important one was 'healthy baby, healthy mommy' and both of those were met. Each person we came in contact with respected us and we felt very much a part of the decision making. I tried so very hard to not have high expectations for the birthing day (or days), I wanted to focus on the end result and trust that those who were caring for us were only doing what they thought was best. It was so important to me to try to keep perspective and to not allow small changes or disappointments to cloud the whole experience. Somehow, I managed to do this and for that I am grateful.

Here is Sugarbeet less than 15 minutes old, just after they gave her back to me:

And here she is at 14 weeks, 4 days, with the nurse, G, who helped deliver her (we went to visit to say thank you - and please excuse the dazed look, she had been awake for about 30 seconds at this point):