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Posts Tagged ‘baby’

out with the tide

I’ve been trying for days to write about where we’re at with my son; his behavioral challenges have anted up significantly over the last few weeks and I know I need both the venting and commenter insights this space affords. However I just can’t. Maybe it’s too fresh, I don’t know. Words just won’t come. So, I’m going to punt that topic for now and try to do Peep’s birth story instead, which itself is 4+ months overdue.

So!

I’ll skip the days (weeks!) of prodromal labor, during which I contracted sporadically during the day and regularly during the evenings, for hours on end. Instead I’ll start two days before Peep arrived. It was early Thursday morning, around 3:30 am, when the contractions hadn’t stopped all night and seemed to be worsening, that I finally woke my husband and pronounced it Go Time. We called our friends, and husband took the two big kids over to their house while I put a few last-minute items in the hospital bag.

While husband parked, I shuffled and panted my way up to L&D triage, which was blessedly slow and they got me in a “bed” very quickly. We watched my contractions on the monitor, and I felt so validated as the enormous double peaks scrawled across the paper; the contractions weren’t a figment of my imagination nor just trifling little cramps. They were real, they were strong, and they were frequent. They just weren’t doing anything much, so I was sent home after a few hours. Oh, that long, hangdog slog back out of L&D. I felt like Napoleon, slinking from Waterloo.

We arrived home just as the kids would be heading to school. We let our friends know, and that we’d play pickup by ear, and I grumpily settled in bed to continue laboring ineffectively. (I should mention, at this point, that my separated pubic symphysis prevented me from walking or exercising my way into stronger labor; any movement hurt, even rolling over or trying to sit up.) 

The minutes and hours crept by in a strange, slow blur. My mother arrived in the afternoon, and she and my husband talked in hushed voices while I tried to rest. The contractions didn’t diminish, but they didn’t worsen, either. I manuevered and re-positioned constantly, trying to find any spot that would give even the slightest relief. We decided that while we didn’t know when things would actually get going, it was best not to let the kids come home and see me in this much distress. I was having a hard time moving through the contractions, and I didn’t even want to see them and try to put a happy face on. Our friends picked them up from school and would keep them for the night. I knew they’d be thrilled to have this extended sleepover with their besties, so I didn’t worry about them too much.

That evening found us back in triage, I was contracting regularly still, and they felt stronger and more intense to me, but upon being checked – by the resident with the world’s biggest hands, just think on that for a minute – I hadn’t progressed beyond 3ish cm and so I couldn’t be admitted. 

I can’t remember if I cried. I probably did. By now it was late Friday night, I’d been awake for two days, was in constant pain, and was SO TIRED. They gave me a shot of morphine and sent me home again. By the time I was back in my own bed, the morphine was working and the contractions felt like a mere dull roar. I slept for three hours, until I woke again to pain so intense I white-knuckled the headboard and moaned – no, growled – for my husband to apply counter pressure. (I’ve heard women speak with awe and amazement at how primal childbirth is, and how our animal nature takes over, etc. That may be true, and I do truly appreciate the magical insanity that is labor and birth. However. I do not like the strange, deep, bellowing sounds I emit when in that kind of pain. It just makes the whole experience feel even more out of control and surreal.)

This phase lasted until dawn, every contraction rendering me a gasping, sobbing wreck, desperately clutching my own ass in an undignified attempt to find leverage on the pain and subdue it. At some point during the morning I decided I had to go back to the hospital, if only to get more morphine. While the thought of riding in the car was unbearable, and the thought of having to walk out of L&D again even more so, I just could not manage the pain at home on my own. The breathing, the stretching, the focal points, the meditation, the music… I’d tried it all and come up short. I needed help.

Saturday mid morning found me in the same bed in triage, getting checked by the same large-handed resident. (“That’s the guy,” I hissed at my mom when I saw him outside the door.) I dreaded what he would say, dreaded hearing that my cervix continued to clamp itself at an uncooperative number, dreaded being in labor purgatory for another indefinite, insufferable stretch.

“Well, that’s a six!” he pronounced brightly, and everyone in the room cheered. I was beyond relieved. So far beyond. I think my husband was, too. He’s one for action, and all the limbo was driving him crazy.

It took the usual amount of rigamarole to get me up to a delivery room, and I remember upon arrival my mom and husband exclaiming over the beautiful view of the mountains, and feeling a twinge of sadness that I couldn’t enjoy it properly, what with the miserable pain and all. I decided I wanted an epidural, despite my desire to go without this time. When I had imagined myself having an unmedicated labor, I had imagined that the hours leading up to delivery would be brief; third babies, after all, have had the way well-paved. What I didn’t know was that I’d be awake for nearly 48 hours and be in active labor for more than 20 of those hours prior to delivery, and would have burned through all my reserves before the action even got started. So even though it wasn’t what I wanted, it was what I WANTED. 

My nurse was super nice, young but warmly maternal and gentle, getting all her intake chores done while making me feel like she was completely focused on me. My mom and husband called various family, letting everyone know that things were happening. I sweated and struggled through every contraction, hoping that the anesthesiologist would hustle it up already. She arrived, young like the nurse but brisk and utterly lacking in bedside manner. “Hold still,” I remember her saying, as I shook silently with the effort of not writhing through a contraction, trying to curl into the proper C-shape that would open my vertebrae. My husband held my shoulders, and as the epidural took effect, I said something about how it was weirdly working feet-first, looked up at him, and that’s the last thing I remember for a while.

It turns out the anesthesiologist punched the needle too far, into the subdural space, but didn’t realize it and injected the full drug load, which instantly bottomed out my blood pressure and caused me to lose consciousness. I was out for about two hours, which on the bright side gave me a nice break from the pain marathon, however it did cause my mom, husband and nurse a serious case of fretting. Fortunately I didn’t go into respiratory distress, which can be common in these situations; unfortunately later that night I would get the first pangs of a resulting spinal headache, something I wouldn’t wish on my worst enemy.

The return to consciousness was slow. At first I was aware of voices and sounds around me; slowly I realized they were talking about me, but I couldn’t hear what they were saying. I didn’t know what had happened, or even if the baby was ok. I managed to open my eyes and my OB’s face hovered over mine. Her lips were moving, but nothing was making any sense. I must have managed to ask about the baby, because I remember finally understanding her say “the baby is fine” over and over. I think I was crying, I was certainly disoriented and scared.

As my head cleared, I realized I had no sensation in my body and couldn’t move. The perks of this situation were immediately obvious: no pain! Gradually I was able to talk and understand more about what had happened. I was still in labor – the contractions were merrily chugging away on the monitor – but couldn’t feel a thing. My OB pulled up a chair and said it was time to go over the game plan.

Up until now, the game plan had been to go for an unmedicated, vaginal delivery if circumstances allowed. My previous baby had macrosomia and shoulder dystocia, and we’d had conversations about the probability of it happening again with this baby, and what the best management strategies would be. (You can read more about it in my last post.) 

Now, the long labor and failed epidural threw me a curve ball. At least, I felt it did. The OB was honest and said she really didn’t know at this point what to recommend. A c-section would obviously eliminate the chance of shoulder dystocia, but carried its own risks and difficult recovery. However, she said, if I was going to proceed with a vaginal delivery, I had to be ok with her breaking the baby’s collar bone or breaking my pelvis to get her out, should a dystocia occur. No, I said. No. I’m not ok with breaking the baby.

I thought and thought and thought, and felt like a c-section would be the safest path for both me and the baby. I couldn’t face getting another epidural after the last one failed so spectacularly, but I didn’t think I could get through delivery at this point without one. I was afraid I didn’t have the strength to push, after everything I’d been through. I didn’t think I could squat or get into optimal positions for getting the baby’s shoulders through. I just didn’t think I had it in me anymore, as much as it hurt to admit it.

My husband told me he’d respect my decision, but reminded me how much I wanted to do this naturally, and told me he believed in me, that everything that had led us here was fate. He wanted me to try. That he had so much faith in me meant a lot, though I didn’t think fate had anything to do with anything. 

During this conversation the feeling was returning to my body. The contractions broke over me in waves, bearable at first, but growing quickly in intensity. The pressure was on to make a decision. I really was leaning towards a c-section, the last thing I thought I wanted, but now suddenly seemed like the safest path. I looked at my mom; she nodded. She wanted me to choose safety. She believed in me too, believed that I knew myself enough to make the best choice.

As the decision slid into place in my mind, another kind of sliding was happening. I felt something shift and move down below, a strange but unmistakable sensation. “Oh my god, she’s here,” I gasped. “THE BABY IS IN MY BUTT.” (Because that’s what it felt like, and because my subconscious knew this birth story would need some humor later, apparently.)

The doctor’s eyebrows went up, she checked me, and it was true: I was at a 10 and ready to push. “It looks like she made this decision for us,” the OB said, and the room kind of started whirring around me, suddenly full of people running back and forth and moving things around and clanking the bed into its fully functional position. I remember looking down and everyone had white galoshes on. It’s one of the visual details from the entire experience that stands out the most.

Meanwhile the contractions were raging full steam ahead, and while I was relieved not to have to dither about what to do, I was also having an incredibly difficult time getting through each contraction. Grabbing my hips, scrabbling backwards in the bed like I could escape them, breathing through pursed lips so hard I was spitting all over everything. My husband and mom were holding my hands, encouraging me, but none of it got through. I was very near panic.

“Open your eyes,” my OB said quietly. “Open your eyes. Look at me.” So I did, and it somehow helped. “Stay here, stay with me.” She was gentle but so authoritative that I just somehow did. I still felt crazed with pain, but also more grounded in knowing that the only person who could finish this was me. I took a huge breath and started pushing.

The pain was unbelievable. Indescribable. Stretching, searing, hot, impossible. Just as I thought to myself I wouldn’t be able to do it long enough to get the baby out, the OB said, “Her head is out!” and I was stunned with gratitude. I pushed again, against the stirrups, against the pain, against the fear that had been building to this moment. I felt like a wild thing, a hurricane, a supernova: the sensation of opening was slithery and explosive and unbearable.

“It’s out,” the OB said, her shoulder is out.” Everyone cheered, and I cried, incredulous. Her shoulder was out. She was going to be ok. One final push and the rest of her slid through me, like the tide going out. And suddenly there she was, nestled in the OB’s lap, a deep yellowish purple, eyes tightly closed. I stared and stared, drinking her in. “She’s not crying,” I cried, as they lifted her to my chest. She opened her eyes. 

I don’t remember the order of what happened next. I know she spent some time in the warmer, and I got cleaned and stitched up, and she nursed, and my husband and mom held her. I know we all marveled at her, and the path her coming had taken. Mostly though I just remember holding her, looking into her face, and her looking back into mine.

 

 

*David Copperfield

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spark of life

Big news! I’m pregnant! And… due in ten days! Uh, and absolutely terrible at updating this blog. Sorry. But anyway, baby #3 is coming soon, and we’re very happy and excited about that, despite knowing full well that the impact of a newborn will be a mixed bag for our family. With a 10 year old and almost 7 year old, we’ve gotten accustomed to the luxuries of life without nap schedules, or diapers, or choking hazards, and revisiting all that will be… interesting, especially for the big kids.

If you follow me on twitter, you’ve probably blocked me by now, because in recent weeks I’ve gotten very vocal (ok whiny) about wanting to get this baby OUT already. I feel like an asshole about it, because I know so many people would give anything to be pregnant and can’t, or have had horribly frightening experiences with preterm birth, and that my seemingly “I’m so uncomfortable I can’t stand being preggo ANY MORE” tweets must appear shallow or offensive or both. I don’t want to offend or alienate anyone, of course, yet I can’t be disingenuous about my own truth, either.

Here’s the thing. I want this baby out NOW because I am absolutely terrified what will happen if she stays in another minute more. My last baby was macrosomic, and his shoulder got stuck during childbirth. This is called dystocia, and is highly risky both to mother and baby; because the head is already delivered but not the chest, the cord is compressed against the baby in the birth canal and the baby suffers oxygen deprivation. This can be fatal, or cause brain damage, or permanent nerve damage and paralysis, or or or. 

There are a few things the medical team can do to help free the stuck shoulder, including breaking the baby’s collarbone (GAH, I KNOW) or performing something called the McRobert’s maneuver on the mother: pushing her knees up somewhere behind her ears and then applying significant pressure to her pubic bone to release the baby’s shoulder. The latter is what they did in my delivery experience, resulting in a perfectly healthy baby, thank the stars, and a separated pubic symphysis and dislocated pelvis for me. This took months and months to recover from, was extremely painful, and limited my physical activities (such as, you know, walking) severely. But I eventually recovered, and life went on, save for the occasional modified yoga pose so the teacher wouldn’t get sued if I dislocated my hip.

Flash forward to this pregnancy: pubic bone separation begins around month 7, which, ow, but ok, I’ll try to work with it. And then an ultrasound at 36/37 weeks shows the baby is already clocking in at eight and a half pounds, “on track” to be a little more than 9 and a half pounds by my due date (same as my son was), according to the doctor. I sputter something about margins of error with ultrasound sizing and am reassured that a previous history of macrosomia reduces that margin. Not to mention, a previous delivery with shoulder dystocia significantly increases the odds for a repeat scenario.

So. My pelvis is already destabilizing, there’s a giant baby percolating in my belly, and she’s likely to get stuck. Obviously the risk to her scares me, obviously I’d prefer not to dislocate my own bones to get her out, obviously this is a double-plus ungood scenario and excuse me if I feel perfectly justified in eating pineapples, eggplant and sriracha in an attempt to jumpstart labor. Yes it’s early and generally not recommended, but: macrosomia, dystocia, pubic symphysis — maybe not on the same panic scale as preterm labor and NICU stays for some people, but definitely waaaay up there on mine.

We all have the lens of our own personal experience that colors how we view the experiences and decisions of others, and I am not guilt-free when it comes to judging others based on my singularly anecdotal evidence in some situations. But lately I’ve felt guarded in expressing my fears and frustrations with remaining pregnant, because the common party line is that it is always better to wait for a fully cooked baby than risk getting her out early, and I feel like people must thing I’m some kind of shallow idiot to want otherwise.

I’m lucky that my OB has made me a solemn vow to do everything to protect both the baby and I no matter what happens, that we will make decisions together as a team, that my fears are completely valid and if the baby gets stuck we can try some other techniques first (for example the Gaskin maneuver) if time and circumstance allow. She supports my idea that going without an epidural will give me greater flexibility to get into positions that could reduce the risk for dystocia and promises that the nursing team will also be very supportive in helping me get through an unmedicated labor. She gives great and reassuring hugs at the end of each visit and I feel safe in her hands. I wish I felt just as safe in talking about it out in the world at large, but the truth is, I don’t. 

And I know that’s part of the joy of living in a world of free & unfettered speech; that we don’t always hear what we want to hear, or get validated in the way we hope. That people may not agree with or even disapprove of our ideas. That even a civil and respectful dialogue about it may still hurt. I know all this, and yet, a part of me wonders if my body isn’t releasing the baby yet because my heart is still in its own infancy and needs the validation and support of entire, multiple communities before it can let go and fully trust that all will be well. 

This self-doubt, it’s frustrating. And also oddly reassuring; I’m just one little human, trying to make another. Wish me luck?

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