The Ironman of Childbirth and 1 week old

Hi Friends! I’m sorry to have left you hanging for so long! In addition to being generally shell shocked by the fact that I have a baby (!!!), there is also the exhaustion of new parenthood and the recovery from a major abdominal surgery. But I finally pulled the computer out so I could write an actual update while the dude naps next to me in the boppy and La and her mom are out buying a mattress for our guest bed (so La’s mom can sleep on something other than a somewhat sub-par air mattress for the rest of the week!)

I thought I would give a more complete account of our marathon birth experience, both for y’all who are interested (I realize you got some highlights here, but not all of the play-by-play) and for general posterity.

Day ONE (Fri 3/14/15): We got up early and headed out to meet our doula at the hospital for an external cephalic version to turn the baby from breech to head down. We arrived at 8:45, were admitted to labor and delivery, and shown into a room. The procedure was explained, we met Chad the hot anesthesiologist, we signed consents for both the ECV and c-section (because if the ECV didn’t work, they would proceed immediately to c-section.) And then we waited. And waited. There were two scheduled c-sections in front of us, and then two more emergency c-sections that came up. The entire time, I was both starving (NPO since the night before and I am not good without breakfast) and hella anxious. Finally, around 11am, the resident came in to do a scan and check out his position and discovered . . .he was happily head down, all on his own! NO ECV necessary! The resident felt bad that they hadn’t scanned me hours earlier and saved everyone some time and anxiety, but in the end, it was excellent news.

I was allowed to eat my first of many sub-par hospital meals, and then they began the oral doses of cytotec to start the induction. After each dose (4 hours apart), we were hooked to the external monitors, which kept us chained up in bed for an hour or so after each dose. We were feeling hopeful and excited, taking bets on when he might be born – La and I were set on Saturday afternoon, our nurse Karen said Sunday morning. By evening and two doses, nothing had changed (I didn’t have any cervical checks before this or on this day, but the monitors showed a flat line as far as my uterus was concerned) But we continued the cytotec through the night, and I scored some ambien to get some good rest for what we were hoping would be an exciting saturday!

Day TWO (Sat 3/14/15): I had my first cervical check, which found me to be 0- 1/2 cm dialted, not even enough to put the foley bulb in, which was disappointing. By Saturday morning, I’d taken all 6 doses of cytotec allowed, so in the late morning I got up and started doing laps on the L&D floor to hopefully encourage the baby to come down on my cervix and get things going. They decided to try and place the foley later in the afternoon, using some ‘tricks’ but it wasn’t successful (just really fucking painful.) After a no-go there, I was started on pitocin for the night, which requires constant monitoring – which sucks. Another ambien and good night of sleep, despite having someone in my room near constantly to readjust the monitors. On the upside, the monitors were able to pick up some small but regular contractions, a good sign.

Day THREE (Sun 3/15/15): Things were definitely starting to feel defeating and frustrating at this point. I was glad that we were being given every opportunity possible to have a natural, vaginal birth but I was also beginning to need something to change. We had spent so long walking the same circuit of halls, repeating mantras of ‘open, open, open’ – thinking of any possible way to pull the energy of labor toward us. They checked me again and found I was now open enough to try the foley bulb again – this time, they recruited the chief resident, who has a special touch when it comes to foley bulbs! She was amazing, and got the bulb in – with minimal (but still significant!) pain. They doubled the average liquid in the bulb to hope and speed things up. They also let us go for a walk outside – which was glorious! We kept walking and bouncing and trying to let gravity and the foley do their job! By the end of the day, I was 4cm dialted thanks to the foley bulb, and was having regular but mild contractions about 5-7 minutes apart into the evening. I took another ambien and dreamed big about having a baby the next day. In the middle of the night, the foley bulb fell out and I lost my mucous plug. Signs were ointing towards birth!

Day FOUR (Monday March 16, 2015): Until this morning, when the contractions had slowed to almost nothing. No cervical change. Cue a lot of tears and frustration. It felt as though every step we took forward was met with a standstill or steps back. Back on the pit we went. I spent hours on the birth ball, bouncing and watching TV and hoping the pit would kick in and take my 4cm cervix to the next level. But nothing happened. In the afternoon, my cervix was checked again and during the check, my water spontaneously ruptured. Two giant gushes of what the midwife estimated was over a gallon of fluid! She thought I might have had polyhydramnios – excess fluid, which had helped baby turn breech (and back) and had also kept me from progressing well. The midwife guessed me to be about 4-5cm dilated as well. We were all hopeful that something would finally happen, thanks to this significant change. We got released to go walk outside again, and our dogsitter brought the pups to come visit – which saved my spirit. But there was very little progress after water breaking – no contractions, no further dilation. We were heartbroken, and the midwives were beginning to feel that it was time to have a clearer lan with an end in sight. We’d had shift changes of midwives and nurses every 12 hours since Friday, which was also difficult – although we loved them all, and they were all certainly ‘on the same page’, slight variations in plans meant we could usually only see the next step illuminated. It was time to have a clear plan. The midwife on call determined that we would start cytotec again though the night, then switch to pitocin again in the morning if needed. And if adequate progress wasn’t made by the next night, we would look at a c-section. We knew we were going to have a baby the next day. Finally.

Day FIVE (3/17/15) I woke up to no contractions, deeply depressed. Cervical check showed some effacement and softening, but no further dilation. Back on the pit. They also decided to do an additional scan to determine if he had possibly flipped again. At this point, we found him still head down but ‘sunny side up’ – which was also likely impeding progress. The midwife decided to try and turn him manually. This is also not a particularly pleasant experience, if you’re curious. She was able to turn him face down, and they placed an internal vaginal monitor to better track contractions as well. Almost immediately after turning him, I began having significant, very regular and powerful contractions. They quickly went from 5 minutes apart to 3 to about 2, and grew in strength as well. After close to 5 hours of active labor with fast pitocin contractions, I opted for an epidural – not my plan, but as no other part had been either, I let it go. The epi was awesome, although it took about an hour to completely lose feeling – a large ‘window’ on my right pelvis maintained feeling, but even this was more manageable than the full body contractions. Once the epi fully kicked in, she checked me again and found that despite the active labor for quite some time, I had still not dilated past a 6.5 and, the baby was back to face up. They determined it was best to give him an internal monitor as well, and she again tried to turn him – this time, without success, and with some impact to him. The next few hours, contractions continued, but now baby was having significant decelerations with each contraction, and not returning as quickly as he should be. After some monitoring, the midwife came in. Things were not really moving, although she wasn’t ready to ‘pull the plug’ (so to speak) just yet and go to a section. We asked, though, if it seemed that was where we were headed. Yes, it did. It was also just a few hours from the shift change, when we would have yet another new midwife and nurse, after a long and emotional day with them. And La said, ‘I don’t want this to turn into an emergency, where I won’t be able to be there with you.’ And it hit me – it was time. We needed to go forward with the c-section. So, we decided it was time at about 5:30pm. At 6:15, they wheeled me back to the OR. Right before I went back, La and I decided on his name: Ansel, divine protection.

I’m not going to lie, a C section is not a super pleasant way to give birth. They strapped me down, upped the meds in my epi, and prepped the ER. I’d asked for a mirror to be able to see him when he came out, so they set that up next to me. We also had our nurse and midwife there, who would let us have skin-to-skin ASAP if at all possible. La was let in a little later, and then they started cutting. I felt like a bowl of jello being dug into, which was not painful but also not fun. I could hear them talking – announcing progress, through the skin to the uterus, through the uterus. And then they said something about the cord, and ‘double nickels’ and then I realized they were saying his cord was around his neck twice. I never saw him in the mirror, and then La was up and running away from me and towards the baby. There was no loud cry. I started crying through the epidural shakes. The anesthesiologist, a tattooed guy who had been deeply impressed with my management of pre-epidural contractions, told me calmly that his daughter, also born by c-section, had taken a while to get a good breath as well, but she’d come through and so would my guy. The five minutes that I laid strapped to the table hiccup-sobbing, straining to hear whatever was being said or done to my baby, were the longest of my life. Finally there was a small but significant baby cough, and the air came back to the room – he was breathing. It turns out, he’d been slapped and rubbed down and finally bagged before he took that breath, turned from blue to pink and popped his giant eyes open. Because he’d taken so long to breathe and had an initial apgar of 5 (later, it was a 7), they sent him to the NICU. La went with him and insisted they show him to me before they took him. So I got to kiss his tiny cheek and see his big eyes before they whisked him away.

They sewed me up and observed Ansel, and we met back in the recovery area about an hour later. La put him on my chest and without a bit of hesitation, he opened his mouth big and wide and latched right on. I feel insanely lucky that he has continued to be a natural, champion latcher since then, since we didn’t at all get the birth we wanted, and one of my biggest fears about a section was the impact it can have on nursing. But he latched and sucked for a good 15 minutes! La took him to the next room, where she gave him a bath and talked with the pediatrician while the nurse on my side kept cleaning me up. When we were all done, they sent Ansel up to the nursery to get an antibiotic treatment, as more than 24 hours had passed between the rupture of my membranes and his birth, and I went to our room.

We spent the next three days in the hospital. Ansel had to get more antibiotic treatment and be tested to rule out infection and I had to be monitored post c-section. The day after, the spinal had worn off and I was able to stand and walk with help. By Thursday, I was up and around pretty well – although not without a lot of pain. The combination of the pre-eclampsia, heavy doses of pitocin and c-section had caused my legs from thigh to foot to swell up hugely, which was also painful and uncomfortable. In addition to pain meds and the usual stool softeners, iron and pre natal, they have also put me on lovonox for the next 6 weeks to reduce the risk of blood clots, also increased by the combination of lengthy induction and section.

So, there’s our birth story! It was so long, and exhausting, and I am grateful. Someone asked if it would have just been better, given how things turned out, if he hadn’t turned and we’d just had a c-section on Friday. I don’t think so. I am grateful I had the opportunity to try and labor naturally and have a vaginal birth, even if it didn’t happen. An induction of this length is unusual, but it is evidence based standard of care for our hospital, and I will hands down be suggesting them to anyone and everyone. We had some of the most caring and wonderful practitioners – the same nurse F-M on the day shift (Karen) and an incredible nurse the day we gave birth (Stacey) who stayed long past her shift to care for us after the c-section. All of the midwives were amazing and went out of their way to make me feel supported and capable. I will still have some grief about not having the birth I wanted, but I don’t have guilt or shame or even a lingering ‘what if’ – the only way Ansel was coming to this side of the world was through the “VIP door” and I am ultimately just so glad he’s here.

Things have been predictably, exhausting since returning home. Ansel continues to nurse so well – we had a number of consults with lactation counselors in the hospital, and all of them have remarked on our great latch. They also tested my thyroid and prolactin, since PCOS can impact supply, and found them at great levels. I nurse him on demand, which can be up to every hour to hour and a half, although he’s started giving us some blocks of 2-3 hours as well. The first few nights, he wouldn’t sleep anywhere but on my chest. We’d swaddle him, nurse him to sleep, then put him in the co-sleeper. He’d last about 15 minutes before he’d start moving his feet in the swaddle and wake himself up. In order to get some sleep, I just reclined in bed and laid him on my chest between nursing sessions, but I was nervous. I totally affirm bed sharing for folks who do it, but we have bulldogs and big people, and it’s just not a comfortable idea for us. But after three days of sleep in 1/2 hour to 45 minute increments of nervous sleeping, I knew it was not going to work. After soliciting one of the mom groups online, where the rock n play was roundly promoted, I found a used RnP for $20 and we snapped it up. We also decided, given his incredible latch and great weight gain, that we’d use a pacifier very sparingly. These two items have saved my life (or, at least, given me enough sleep to feel like a human being – a very sleepy human being, but a human nevertheless.)

Ansel has done a great job with weight gain and other goals. He was born at 6lbs 5&1/4 ozs. When we left the hospital, he was at 5lbs12oz, and then down a bit more at his first ped appointment on Saturday to 5lb10oz. My milk came in early Saturday morning, so we were hoping he’d rebound quickly – and he did! By Monday’s weight check, he was at 5lb14oz, and by the lactation appointment on Tuesday, he was at 6lbs even! Given his rapid gain, it’s clear the dip was due to my milk, and now that its in, he’s gaining 2 ozs a day! We’re hoping he’ll chunk up quickly.

Well, that’s the haps, Y’all. Sorry for the long absence and the even longer update. It’s shocking how, even though I feel like all I do is nurse a baby, I don’t feel like I can do much of anything else. I’m slowly starting to tackle other tasks each day, but am also trying to take advantage of La and her mom being home this week so I can rest and heal as much as possible before I’m on my own. Goals for the next week include filing my taxes and going for a walk every day.

And now, here are some pictures! Ugh . . .pictures are not loading . . .will try again soon!