Monday, August 9, 2010

Lilly's Birth Story

So, here's my (graphic and long) birth story for my first baby, Lilly. It was written about a month after I gave birth and this is the version with names removed (some of my feelings have changed since then, such as knowing that the cesarean was iatrogenic, most are the same) and Lil's pronouns corrected:



At 5:30 am on Saturday morning, October 14, 2006, I woke up after two hours of restless sleep. Contractions had pulled me into consciousness and I tried in vain to roll over and get back to sleep for a half hour before their intensity and frequency caused me to start moaning in frustration. I was sure that they were false labor contractions, yet again, or perhaps just revenge from the Mexican dinner I had the night before. I curled up onto my hands and knees for a little while, then got up to whine around the house because I was tired of looking over at the clock ever four minutes to time them. It was actually the first time I'd actively timed my contractions from the onset.
I sat on my labor ball and went online to whine some more and express my frustration and fears until I couldn't think through the pain anymore and went back to bed. My whimpering and moaning woke hubby up at about 10 am and I asked him to run me a bath. When it was ready, I happily sunk in up to my chest and marveled at how the pain vanished. Before, I was sore between every contraction that I had no relief from the pain; it was constant and intense. Now, though, the pain was not only manageable, but I was able to relax and feel good between contractions.

Things were continuing so well that hubby was getting things ready to go to the hospital and calling people to say that we were pretty certain I was actually in labor this time. I, meanwhile, moved around in the tub from a sitting position, doing butterfly exercises in the water, to lying on my tummy and floating and to an all-fours position. I got out to pee every fifteen minutes or so, but quickly hopped back in because it felt so good to be in the water.

While I labored in the tub, hubby made me food and called my doula and a few other people to let them know that I was in labor and this time, it seemed to be certainly the real thing.

At 11:15, my water broke. I felt a relieving pop and warm fluid rushing into the cooling bath water and knew what it was instantly, although I simply enjoyed the feeling for a moment, as it was wonderful. Then I looked down.

"S**t," I cursed upon seeing the yellow and green stream pouring out. I could see clearly that my water was full of meconium. "That's s**t," I said redundantly and loud enough to get hubby's attention. He quickly came and I asked him to empty the water since I needed to get out, but was in the middle of another contraction, so I couldn't safely stand, but didn't want to float in the dirty water.

I stood up and turned on the shower to clean up and the moment I turned it off, the same amount of fluid poured out of me again. So I called to hubby to get me a poise diaper and turned the shower back on. I slipped when my water poured out again as I tried to step out of the tub, but caught myself and didn't fall. I had managed to avoid getting any amniotic fluid on myself this time and quickly got into the poise before more could rush out and turned the shower on the tub to rinse it out. Hubby, upon my request, had been calling Labor and Delivery to tell them we were coming in.

Now I knew that this labor was real, I was excited and tried to go over every small detail before we left. We fed and watered all the animals and gave the kitties a can of wet food as a treat as well. I put two of the open-cage-door parrots in their cages and latched them, feeling bad about how long they would have to be in there, but satisfied that they would be safe and gave them extra toys. I had to keep going back to the bathroom to change the poise pads as what felt like gallons of water emptied from my womb.

We finally got out the door and piled everything in the van and went to the hospital, a fairly uneventful drive during which I called several people who had asked to be called when I went into labor--the ones that hubby hadn't called already, that is. It was a comforting distraction through the intense contractions.

We arrived and checked in and were set up in a room, where I changed into a hospital gown, happy to have not ruined my clothing or stained anything with the mess I could have been making everywhere. We met our nurse and then my doula arrived as I was being monitored to see how baby was doing. We went over a few things that would have to change from my birth plan due to the meconium, such as the fact that I would need to be constantly monitored. However, the pleasant surprise was that constant monitoring no longer meant being stuck in bed.

I did spend quite a bit of time in bed, as it was easiest for the monitoring and being on my back allowed me to feel the baby moving down a little. They brought in a labor ball, but I didn't get to spend much time on it as it interfered with the heartbeat monitor; which was really too bad since I felt myself making progress when I was on the ball (and it irritated me when everyone tried to adjust the monitor to hear, so I just abandoned the ball).

I was at four centimeters when I was first checked and five during the next. It made it look very promising to be a quick birth. I realized I was staying the bed too much and decided to try dancing/swaying, so I got out Deftones' White Pony CD and my discman and started to enjoy it quite a bit. During Feiticiera, the first song, I tried to use my (attempted) soft singing to move things along during contractions. I was really into the dancing and singing by Digital Bath--a song that has always felt like a birth song to me and was the first dance at our wedding--when the nurse came in so frequently (as they were changing shifts and introducing me to my new nurse--who said "Hi, my name is [] and I've had six natural births and been a Bradley Instructor for 12 years.") that I had to stop too many times and sadly, gave up trying to listen to music.

Much of the next few hours were spent with routine exams, contracting and breathing or moaning through them with my doula gently leading me through the breaths and encouraging me. I had a habit of forgetting to breathe or getting so relaxed that when the next contraction would come, I'd start to panic, but my doula was there, breathing next to me and it would pass in seconds. I had many visitors, which I enjoyed throughout the whole day. My mom snuck me in a cheeseburger and I ate some Jell-O I hid and brought with me. The food kept my strength up, since I started with so little sleep.

During this time, though, hours passed with each dilation check being the same: five centimeters. Finally, it was time to talk about pitocin. My contractions had slowed and seemed to no longer be effective (they weren't even really painful anymore, even). They hooked me up and my contractions came back. While not more intense than the earlier ones, they were more frequent, like they were in the morning, so into the jacuzzi I went.

The water once again helped with the pain, but I had to roll so my belly was out enough that the monitor wasn't under, as all it could hear was water. The nurse tried two different mediums to get the monitor to pick up under water, but no luck. I stayed in until it was time for another check and was still at five cm.

During this time, I had been having trouble with my fluid drip stopping. I'd had two doses of penicillin and was okay with them, although the second was a little achy. Well, while I was laboring in the bed after the check, I had a whopper of a contraction, thanks to the pitocin.

From my perspective, what happened is that I was doing okay in the beginning, but breathing wasn't doing it, so I moved into moaning. But the pain just seemed to keep going on and increasing and eventually, it tore a scream out of me, I couldn't handle it. Then the nurse was putting an oxygen mask on me, saying the baby needed oxygen and everyone was telling me to breathe. The nurse was also saying they had shut off the pitocin. I was a little confused, but thankful that the pain had stopped and wondered when the baby had been checked. Hubby made a joke about my Darth Vader mask and I joked back.

What I didn't know and was told a couple days later was that there was three to four minutes between the scream and the mask. Hubby said that my eyes rolled back in my head and I went limp and stopped breathing. The baby's heart rate started dropping, then they lost them on the monitor entirely. They finally turned off the pitocin and I came to. I have no memory of it at all. But I scared everyone and no one told me, since I didn't need more to worry about.

I guess what had happened was the my fluid drip stopped dripping and the pitocin had been increased a few times before it did, so I was delivered raw pitocin and my body didn't like it. So once they figured that out, the pitocin went back on at half the dosage. I tolerated it just fine, my contractions were just more frequent and while there were still a few that I couldn't just breathe through, it was all manageable.

I had visitors all day and it really helped me get through the day--it seemed to fly by and I probably spent more time in bed than I should have, but I started out depleted and didn't really get better, except for a few hours after I ate.

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The nurse came and talked to me about how things might have to change if I still hadn't progressed and then she did the check. Eight centimeters. I cried with relief--all those contractions WEREN'T for nothing. A little while later, my equipment malfunctioned again and the penicillin that was supposed to take about 30 minutes to empty into me emptied in 8 minutes. The pain was so intense it totally stopped my contractions and left me with the strong desire to rip my arm off and beat the IV stand with it. They kept telling me to calm down, but I was in so much pain that I couldn't. It was hands down the worst pain of the entire labor, pushing phase included. When the bag emptied, the pain stopped. Again, no one bothered to tell me that there was a malfunction; they just let me think I was a wimp. My mom yelled at the nurse when I was yelling about the pain and she was unsympathetic. I wonder if she cared later when she found out I wasn't reacting to a normal dose.

I don't remember a lot from there, just that a short while later, things started to change. The contractions became harder and I threw up (Jell-O--it was actually very easy to handle, although I still yelled about it--I REALLY hate vomiting) and when I was checked again, I was at ten centimeters and fully effaced. I was told I could start pushing as soon as I felt the urge to bear down.

She said it was important to push now because the baby was still so high up and of course, the clock was ticking since I was 15 hours from when my water broke (only 18 hours was allowed for GBS+ mothers--stupid and defeatist). So at the first urge, I started trying to push.

It wasn't long before things felt wrong, though. I felt my body fighting me and every time I tried to push, the baby didn't get lower and the pain became immeasurable. I couldn't keep up the entire ten count that the nurse tried to get me to push for--I even tried to say that wasn't how I wanted to push, but things were very confused and I couldn't really form complex thoughts.

I moved from position to position--squatting worked the best, but I didn't have the strength to maintain it. At this point, I had been going on two hours of sleep and a couple five to fifteen minute naps for over twenty hours. I was exhausted, in tremendous pain, trying my hardest to push while my body fought me and kept telling me to stop, but the nurse kept telling me to go and everyone was saying I could do it.

After an hour, I knew they were wrong. My body was telling me, over and over, that I needed to stop. Something was wrong and I knew I couldn't get my baby out the way they went in. But all I could communicate was the physical--"I'm tired" "It hurts" and finally, "I can't do this." My support misunderstood and tried to cheer me on, but I really felt like I couldn't go on and I was getting scared because the feeling that something was Wrong was growing until it was all I could hear from my body anymore. Another nurse even came in and tried to help me, encouraging me to get back into the squatting position and moving around, but it was finally too much. I was flashing from moment to moment, having difficulty focusing on anything and all I could think of was the need to sleep and the need to get the baby OUT.

I want to note here that if it weren't for my doula, my husband and even the nurse, I couldn't have made it through feeling as good as I did. As bad as things got, they kept me going and believing in myself until my body told me "good job, but this has to stop."

Finally, to express how serious I was, I got in the bed, lied down and just gave up and cried until they understood that I didn't mean it was just the pain and exhaustion. I was reminded that the alternative was a cesarean and in my head, I was answering with "Yes, I know, I NEED HELP," but I couldn't get it out. A nurse offered an epidural quietly and I wanted to say yes, but the words wouldn't come out. The things I WAS saying were awful, but I wasn't in my right mind by any means (why no one recognized this as transition is beyond me). After I had made the decision to have the cesarean, I was depressed and terrified and didn't care about anything. I was panicked and hated myself.

The worst feeling I had was that I let everyone else down, that I'd wasted their time. I felt like a failure and that everyone was just going to either be disappointed in me or say, "I told you so." But at the same time, I was thinking of my baby and that I wanted them to come out while they were still doing so well inside me and be healthy.

Now that I had nothing to distract me but my own feelings of guilt and failure, I was screaming through the contractions, barely conscious of anything around me until one nurse grabbed my face and told me to be quiet because I was scaring the other patients. I told her I didn't f***ing care. Then it was a blur until they were taking me into a room and telling me that my husband couldn't go in with me, so I started yelling at them. They ignored me (except to tell me to be quiet again) and yelled at me to get up on the table and sit still.

All I wanted was my husband's hand to hold while they shoved a needle into my spine, but at least I was "allowed" to have him stand in the doorway. They were worried about him making the anesthesiologist 'nervous.' Why the hell should I care and why should he be nervous if he's doing his job right? No one seemed to give a damn about me anymore, which reinforced my feelings that everyone was angry that I'd wasted their time and now they just wanted me out of there. This was the worst part of the whole ordeal.

They gave me a spiel about how I needed to be very still, even if I was contracting. So of course, my body started contracting HARD, when I had finally been in a lull. I had three contractions (and the first real urge to push) while the needles went into my spine and I held onto the nurse in front of me, desperately trying not to move. My whole body was shaking and I heard the anesthesiologist cuss and I thought he was mad at me (turns out, he was cussing about a piece of equipment breaking) then I felt what seemed like warm water all over my back and I was told I needed to lie down. I was barely able to understand them and then everything started rapidly going numb and I laid back.

Everything started to clear then. The pain, the confusion, the psychosis. I could think and finally relax. I was wheeled into the operating room and moved to the table. I saw the straps on the arm board and quickly reminded them that I'd stated no restraints in my birth plan and they responded that I needed to keep my arms on the boards then. Fine, I'm so phobic of being trapped that I had no problem complying.

They put up the blue screen, the doctors came in and I was tested to see if I could feel anything--I could feel something, but not pain. A minute later, I asked if he had started and he said he'd started 30 seconds ago. I asked a lot of questions, made jokes and enjoyed listening to the doctor hum as he worked. I kept reminding hubby to keep the camera primed (it has a delay I didn't want interfering with good shots) and asked a lot of questions which the doctor answered. Then, about five minutes after asking if he'd started, he warned me that there would be a strange sensation like someone sitting on my chest.

Indeed there was, but the feeling of something being pulled out of my tummy--which is what was happening, followed it. It was the oddest sensation of my life, but then nothing mattered because I heard the baby cry. It was the softest little voice, so deep and quiet and I started crying. It was my baby. Hubby was snapping pictures over the screen. Then, without warning, their head appeared above me and I looked into their eyes briefly as a drop of blood fell on my face, then they were whisked away and I shooed hubby off to follow them. I lied there and listened to them cry as I cried my eyes out. At 3:56 am, October 15th, 2006, my child, Lilly Rose, was born by cesarean birth.

(pictures: birth emergence WTF just happened?)

That was my baby. They came from inside me. They were real and really there. Even now I can't think back on it without crying, the emotions were so strong and powerful, which is so rare for me--I have a delayed response to everything. Not this. For once in my life, I felt at the moment something happened, not later.

Everything after that was just relief. They were safe and healthy. I heard the doctor say, "That's a big baby." And they were talking about their head being too big to fit. But they were also complimenting them and then they were being held out to me. Again, I was filled with that overwhelming mix of feelings--all positive--and just marveled at how soft their skin was. I wanted to take them, but didn't feel strong enough to ask. They were rooting already and time was frozen for a few moments and I got to touch them much longer than I thought they would leave them with me before they said it was time for them to go get their tests.

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I told hubby it was okay for him to go with to the nursery and after he grinned lovingly at me for a few moments, my "Go, go!" got him to scoot off after them. I wanted one of us there for all of their first moments of life outside of me and I was okay with the two doctors working on me. One of them I personally liked and the other, the one who was doing all the work I had two positive opinions on and had found that I liked him upon meeting him earlier in the day. Now that I wasn't nuts anymore, the nurses were treating me completely differently--maybe they understood that I wasn't myself earlier and that I was just panicked.

I asked if I'd be able to try for a VBAC next time while the doctor was stitching me up and he said it shouldn't be a problem. I asked a nurse for Lilly's weight and length and she said that they were 8lbs, 7oz and 19 inches long. I asked after their APGARs and she said 9 and 9. I was later told that they just had purple hands and feet (which are still their cold spots).

It was about twenty minutes of stitching and stapling and then a few minutes of other tests and they were ready to send me to my room. They told me that they were going to roll me and it would feel like I was going to fall but not to panic or move because I wouldn't. Then they tilted me and it felt like I was stiff as a board and not like I would fall as they put a blue board thing under me, then moved me into another bed and wheeled me to my post-partum room, where my doula was waiting for me.

After a little while, Lilly was brought to me and after the third try latched on and sucked like a hoover! To me, they're perfect--more than I ever dared to hope for and the best thing I've ever done in my life. I love them so much I can't find the words. Recovery was hell, but every time I saw them, it was such a tiny price to pay.

There are always maybes--maybe if I'd waited an hour to push, I'd have been ready and could have done it. Or maybe if I'd waited, I'd have been too tired to do the pushing I DID manage. Maybe if I'd done all this at home it would have taken longer, but ended in a vaginal birth. Or maybe I never would have progressed without the pitocin. Maybe if I'd got up and moved around more things would have been different. Or maybe it would have worn me out faster. Maybe they would have come out if I'd been induced two weeks earlier. Or maybe things would have ended the same, only with me traumatized by the cesarean because I had too many interventions.

I don't care about the maybes, or at least, I'm trying not to. What matters is that I did 22 1/2 hours of natural labor and pushed for an hour and a half of it. I let them come on their own time and didn't end up induced. I decided when it was time for a cesarean and thought no one pressured me into it. Sure, I'm not happy being part of that too high cesarean rate in this country, but I'd have been even unhappier if something had happened to Lilly because I didn't listen to my body/instincts. They came out and blew their tests out of the water, outperforming most babies, vaginal or otherwise. I believe very strongly that it was the time I gave them inside and the time I spent laboring and trying to get them out that gave them such a good strong start in life.
first nursing pic
All in all, I'm satisfied that I did my best and they did their best and we are here together now and they're so amazing that I still can't believe it. I love my little Lilly.

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(Having had my VBAC, I now know that my body needed to progress past a 10 with Lilly and I was 'encouraged' to push too soon, which lead to the cesarean. Yes, maybe they really were too big in their hard skull--at 3 years old, it's almost the same size as mine--but I don't really think so)
(This has been further edited to fix Lilly's pronouns, as they were assigned the wrong gender at birth)

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