Sunday, July 20, 2014

The birth story

First off, thanks for your kind messages about Max's arrival and my dad's passing.  It means a lot to me.  And to Tiffany, who is a reader who never commented before - thank you.  Honestly, sometimes it feels like when you write a blog post, you're just writing it for the handful of friends you know read it and comment.  It really touches me that there are people who read this blog and care what happens to me  and my family even if they've never met me before.  I've been a lousy blog commenter.  Please know I've been reading all of your posts, usually at 4am when I'm bleary-eyed and feeding Max.

I have so much to say about Max's first month, about c-section recovery, and breastfeeding, and pumping, and lack of sleep, and hormones, and Dad's death, and executing his estate, and my sister and her family.  But Max makes it nearly impossible to write about any of it.  He's a baby after all, and babies = super needy.  To wit, this post has taken two weeks to write.  But hopefully I'll figure out this parenting thing and Max will figure out this being alive thing and we'll be able to share that stuff with you.  In the mean time, here's the birth story.

Max's birth story.  Friday morning I had my membranes stripped which I talked about in my last post.  I went home that day and I didn't feel great, had a lot of cramps throughout the day.  But it eventually subsided. Jeeves came home and I'm noticed that I was maybe having some contractions.  Jeeves got excited/stressed and thought maybe I should start timing my contractions. But I thought that they were too sporadic and I had low expectations that they would last.

Still, they were definitely contractions.  Jeeves and I went out to dinner and on the walk I decided I needed to start timing them.  I had downloaded an app called Full Term, which I used to time my contractions.  At this point my contractions were completely manageable. They were approximately seven minutes apart.  But near the end of dinner they started to get more spread out and more sporadic.  I was disappointed - I thought that maybe this wasn't it.  We went home. At home they started to pick up again.  The pain was also becoming more intense.   But I could still talk through them.  At this point it was getting pretty late at night and now the contractions were running about five minutes apart.   I was worried I wouldn't be able to sleep through them, so Jeeves recommended that I take a bath.

While setting up for the bath, the contractions started to pick up in time.  Now they were every four minutes. When I sat down on the toilet my mucus plug came out.  When I got up from the toilet about a minute later I started drizzling fluid, but I wasn't sure if I had peed myself or if it was my water breaking.  I didn't want to risk it so the bath went by the wayside.  The contractions continued to speed up - they were now about every three minutes but I was not yet at the infamous 311.  311 means that you have contractions that are three minutes apart, that last one minute for at least one hour.  Contractions have to be intense enough that you cannot talk through them.  It was now getting harder for me to talk through the contractions. However, I had not had them for at least an hour.  But as I was sitting on the bed I continued to leak fluid and I realized it was definitely my water which had broken.

My OB asks that you call if your water breaks.  So Jeeves called because at this point it was getting really hard for me to talk if I was having a contraction and I was having them every 2 1/2 to 3 minutes.  Dr. D, who stripped my membranes, was on call and she told me to come in and get admitted since my water had broken.  I asked to stay home long enough to shower, and she said that was fine.  The contraction pain was excruciating at this point, so it took my quite awhile to get showered and dressed and finish throwing a few things into my bag.

The pain.  Oh, the pain.  I think I have a pretty high pain threshold, I really do.  But this was beyond.  It radiated and intensified, and when it was over, there was still some residual pain.  And only a minute or so before another contraction would start.  Timing them became essential, as I really needed to know when I was half way through one.

We managed to get a car via Uber, and headed off to the hospital.  At this point it was well after midnight and that means that the Brooklyn Bridge was closed for repairs.  There was also a ton of traffic in Manhattan thanks to it being the weekend.  Our driver seemed not to have a clue about which way to go and he kept chattering at me, even though he knew I was in labor.  Eventually we reached the hospital, and made it upstairs to Labor & Delivery, with several stops along the way because I really couldn't walk or move at all when contracting.

The staff and nurses at the hospital were incredibly kind.  They quickly got me into a room, changed into a gown, and onto my side where the nurse rubbed my back through the contractions.  I just lay there and moaned in pain.  First question I was asked: Would I like an epidural.  YES, I wailed.  I think that maybe I could have withstood the pain for longer if I had more of a break between contractions.  But with only about a minute of downtime between them, there was just no way I could ride it out.  I know some people are able to do visualizations and see the pain as productive.  None of that worked for me.

Before the anesthesiologist arrived, Dr. D checked my dilation.... I was only dilated one centimeter, and that was the one centimeter she had dilated me that morning in order to sweep the membranes.  I nearly burst into tears.  How could I be in so much pain and only dilated one centimeter?  I was effaced 80%, which was a big improvement over the 0% of the morning, but still.  I had told Jeeves ages ago that I did not want an epidural until  I was at least 4cm dilated ( I should note that I had also planned to labor at home for a lot longer than I did, and I assumed I would have many hours of having contractions that were at least 5 or more minutes apart) because I wanted to reduce the likelihood of a c-section.  Besides, a lot of hospital won't give you an epidural if you're less than 4cm dilated.... But since my water was broken and they could see the frequency of my contractions, Dr. D said I could have the epidural.

Jeeves asked if I was sure that I wanted one.  My wonderful nurse interjected: She wants the epidural!  She's getting the epidural!  I explained to Jeeves that I just couldn't take the pain - I was exhausted and I didn't see how I would have the strength to finish this if I continued without the drugs.

I'll skip the part about the douchey anesthesiologist and just get to the point - the epidural was fucking magic.  Sitting still was the hardest part because I was having contractions while he put it in, but Jeeves and the nurse helped me focus and stay still.  The epidural did not hurt at all going in - probably because the contractions were so excruciating that I did not notice it.  Unfortunately, my epidural was a little bit one sided, but the anesthesiologist topped me off and rolled me onto my side and that did the trick.  Mercifully, I could finally sleep, and I did for a few hours starting around 3am.

As for all my fears about not progressing after getting an epidural so early - completely unfounded.  I progressed like a textbook case.  At least 1cm every hour and effacement continued.  My nurse left at 8am and I got a new nurse, also very nice (not as nice as my night nurse though).  And at 10am, I was fulled effaced and fully dilated.  It was time to push!

Yeah, not how you figured the story would go, right?  Man, I really thought that once I got to the pushing stage, I wouldn't have to worry about a c-section.

I pushed for awhile, but eventually I needed the epidural turned down so I could feel a bit more.  They halved my epidural and I could now feel the pressure and the desire to push.  So, I pushed.  And pushed.  And pushed.  For over an hour.  Dr. D started to get worried about two things: 1) my temp was slightly elevated and she was worried about infection since my water had broken; and 2) when pushing, Max's heart rate would decelerate quite a bit.  So she decided I needed a break - they sat me up straight and hoped gravity would drop Max down a little lower.  At this point, his head was at the +1 station in my pelvic bone.  Unless he got past my pelvic bone, there was nothing Dr. D could do to help him out - I just had to keep pushing and hope he would come down.

I sat up for about 20 minutes, but when they returned, there was no change - Max was still at +1.  Additionally, Dr. D explained that my contractions were similar to someone who had been given pitocin, even though I had not had any - they came in fast clusters and then there would be nothing for several minutes.  This made pushing difficult.  But back to pushing.  I pushed for another hour, but Max's decelerations continued with every pushing cycle and it was taking him longer and longer to recover.  Dr. D explained her concerns - that his cord might be wrapped around his neck or leg and he wasn't tolerating this well.  She was concerned about him.  I burst into tears, and pleaded that they not let anything happen to my baby.  They calmed me down and reassured me he would be okay.  I pushed a couple more cycles, but still Max did not budge.  Dr. D felt it was time to call it.  Jeeves and I finally agreed to the c-section.

As soon as I agreed, I realized how concerned everyone was about the baby.  They immediately started running me down the hall, other medical personnel came streaking out of other rooms, they yanked a hair cap on my head and got me into the OR.  Jeeves wasn't allowed in until they had me thoroughly numb.  This turned out to be an issue - since they had turned the epidural down I could feel a lot, and they needed to really numb me, which was taking longer than they expected.  At one point, one of the three (!) anesthesiologists in the room told me that if they couldn't get me numb soon, they would have to put me under general because the baby needed to come out.  That terrified me.  But Dr. R came over and reassured me that the baby was on the monitor and doing okay.  Eventually, I was numb, Jeeves came in, and they started.

Within minutes, we could hear Max howling.  He had (has) some serious pipes on him.  Jeeves and I both broke down sobbing when we heard him - all we've been through, and we finally had our baby, and he was okay.  They brought him over to us to see, but whisked him away quickly - standard procedure for a c-section delivery is that the baby is looked over by NICU pediatricians in the OR.  So, they gave Max the once over, wrapped him up and handed him to Jeeves.  Max was still howling, but the moment we started talking to him, he stopped crying.  

Turned out his cord was just fine - not wrapped around anything, so we really don't know why he was experiencing those decelerations other than to say that M'Lord Baby is persnickety and apparently did not enjoy labor.

Jeeves and Max stayed with me while I got put back together Humpty Dumpty style.  That took about 30 minutes, and then they moved us to the recovery room, and I finally got to hold my son.  It was a little hard - one of my arms was pretty numb, but we got to do skin to skin and Max nursed in his very first hour like a champ.

When we got to the recovery room, Jeeves checked my cell phone and saw the texts from my sister telling me about Dad's bad fall, that he was in a coma and not expected to make it.  I cried for the third time that day.  I told Jeeves - it's like a plot point from a Lifetime television movie.  If I read it in a book, I'd find it maudlin and unbelievable.  I later learned from Dad's death certificate that he fell 10 minutes before I started pushing.

As we sat (well, I laid) in recovery, I got worried about whether I'd ever feel my legs again.  But by the time I was sent up to my room on Mother/Baby, I could move them.  I also had bad shakes in recovery, but this is apparently very normal for an epidural/c-section.  It wore off.

After a couple of hours in the recovery room, we got moved to our own room.  Luckily we got a private room.  I'm so grateful for that - between recovering from surgery, having a newborn (who was much more awake, alert, and crying than I had been told newborns are the first couple of days), learning to breastfeed, grieving Dad - I don't think sharing a room would have gone well.

Sometimes I still feel guilty or badly about the c-section - like I failed at the birth or I should have pushed for longer.  But honestly, I have to say that having a c-section was no where near as bad as I thought it would be.  I feel like it's important people know that - a c-section can be okay and the recovery from it can relatively easy.  Was I up and walking around 4 hours after Max was born like some women are after vaginal delivery?  No.  But I was up and moving around the next morning.  

I have so much more to say about our stay in the hospital, and Max in general.  Hopefully it won't be so long before I can write again.

Here's a picture we call Max's selfie.