27 July 2012

Madeleine's Birth Story

On Madeleine's one month birthday, I thought it was time to share the story of her birth. This story is personal and may be considered graphic by some. If either of these things make you uncomfortable, best to stop reading now. And, be warned that a labor lasting more than 24 hours does not make for a short story. :-)

Giving Credit Where Credit is Due
Many birth stories are all about the mother and, to a lesser extent, the baby. The story of Madeleine's birth is a story of our family. Madeleine's arrival is every bit a credit to George as it is to me. When the going got tough, George stepped in and made it possible for me to make it through. He may not appear a lot in the story, but put simply: I could not have done it without him. I thought George was a strong man before, but, after this, I know it.

Although I was under the care of an OB and planning to deliver at a hospital, my birth plan was to labor and deliver as naturally as possible without any unnecessary interventions. Part of this was motivated by my opinion that childbirth is a natural process rather than a medical one; part of this was motivated by my deep and complete hatred for needles. I did not want a c-section unless there was a medical emergency and strongly preferred to go unmedicated.

In preparation for labor, I'd regularly attended prenatal yoga during my second and third trimesters. This helped me to remain flexible and active during the pregnancy as well as giving me positions and breathing techniques for labor. George and I attended both a one-evening yoga for couples in labor class and a one-day labor and delivery class, describing the process of labor and general hospital procedures.

The Big Event
On Tuesday, June 26th (the day before the due date), I woke up with contractions that were noticeably different than the contractions I'd been experiencing for weeks. Realizing that something might be up, I went back to sleep for a few extra hours. Throughout the day, the contractions continued, but they were 15 to 30 to even an hour apart. In the afternoon, I went to my previously scheduled OB appointment, and George and I had an early dinner. At home, we went for a two-mile walk to keep things moving. During the evening, the contractions got stronger and were closer together. (Sidenote: I'm glad I was tracking contractions in the age of cellphone apps.) By bedtime, about 10pm, I felt pretty confident that I was in labor. I tried to lay down, but the contractions were too strong. So, I suggested that George get a few hours of sleep, and I bounced on an exercise ball while trying to finish Half Broke Horses (I did finish it - great book!).

By 1am on June 27th, it was time to call the doctor as the contractions were one minute or more in length, four to five minutes apart, and had been in this pattern for over an hour. I woke up George, and we called the on-call physician, who told us to come in as soon as I felt the contractions were getting nearly too strong and too close to drive in. (Note: we live about 20 miles from the hospital where we planned to deliver.) We showered and finished packing our bags.

At about 3am, we arrived at the hospital and proceeded to triage, where a nurse checked my cervix for progress. She told me that I was not dilated enough for admission, so my options were to get a shot of morphine to numb the contractions for six hours and go home, go home unmedicated, or walk the halls of the hospital for two hours and come back to see if I'd progressed. Given the distance between home and the hospital (and the severe discomfort of having contractions in the car), George and I opted to walk the halls. At 6am, we checked back with triage with contractions now noticeably stronger than when I had originally checked in, and the nurse told me that I had not progressed at all. The first two options were now my only options. Very unhappy about the prospect of sitting in traffic going home and sitting in traffic returning and without any clear explanation of when I should come back, we left the hospital (unmedicated). A mile or so from the hospital, I told George to turn around because we had to go back...and we did. By now, it was about 7am. We returned to triage, were told that I'd progressed far enough to be admitted, and were shown to a labor and delivery room where we were assigned a nurse for the day and received a visit from my OB.

Throughout the morning, the contractions continued, and I was able to breath through them. Although they weren't pleasant, they were manageable as they didn't seem to get closer or stronger and my breathing technique was working. At this point, I'd been awake for 24 hours and hadn't eaten in over 12 hours. Thankfully, my OB allowed me a full diet, so I ordered and ate some hospital food and snacked on some energy bars we'd brought along.

At about 1:30pm, my OB came back to check on me. My dilation and effacement progress were slow, and we all agreed that breaking my water was the right thing to do in order to keep labor progressing. Immediately, the contractions were much (much, much, much) stronger and noticeably closer and longer. I was no longer able to breath through the contractions on my own but rather relied upon George's (awesome) ability to keep me focused and under control through each bout of pain and pressure. I tried several different laboring positions with no relief. This is how things continued throughout the afternoon and early evening. Even though it went on for hours, I don't remember much of it because I tried to stay focused on each contraction as it came.

When my OB finished her office appointments, she came by to check on me again. It was around 6:30pm. I'd been in labor for at least 20 hours and had not slept in 32+ hours. To the shock of all of us, I was only dilated to 4cm. I asked her for the options, and she told me that I could continue laboring as I was, I could get a narcotic to take the edge off the contractions (with the side effect of passing the narcotic to the baby, who would be born in a groggy state), or I could get a spinal epidural. I told her that if we were talking about another hour or so of the strong contractions, I could do it...but that I did not think that was the case. She confirmed that she'd expect me to finish dilating at a centimeter an hour (so about six more hours). I opted to get a spinal epidural, needing both rest and pain relief.

Shortly after 7pm, the anesthesiologist arrived to administer his goods. As he set up, he read me the legal warnings about possible side effects and the like. Even in that moment of pain and exhaustion, I found some humor in my profession interfering with his work. I digress. The process of getting the epidural was less than pleasant as I had to be still and not breath deeply (my coping mechanism!) through very strong and frequent contractions as a massive needle was being weaved through my spine. Despite his warnings that it would take 10 minutes to take effect, I felt relief almost immediately. I could still feel a light pressure telling me that contractions were happening, but I no longer felt the need to respond to them. And, while I couldn't sleep with all the monitors on me, I did get some much needed rest.

Sometime around 9 or 9:30pm, the on-call OB came by to check my progress and found that I was complete (100% effaced and dilated to 10cm). It was time for active labor (aka pushing). I love that this is called "active labor" - as if the rest of the labor isn't active?!

I started pushing around 10pm, and at 10:30pm on June 27th, Madeleine was born. As soon as she was born, the OB handed her up to my chest. As she did, the umbilical cord snapped because (unbeknownst to anyone but Madeleine) the cord was exceptionally short, less than a foot long. Fortunately, Madeleine had already taken her first breath, and this didn't create any complications for her. It did mean that we were not able to donate her cord blood, have the cord stop pulsating before being clamped, or have George cut the cord...but we'd much rather have a healthy baby than any of those things. After such a long labor, it was a beautiful shock to have her arrive so suddenly. We didn't even have cameras ready!

Our labor and delivery experience was a great first lesson in parenting: go in with a plan but remain flexible enough to change course should it become necessary to do so. For example, I never imagined having an epidural (I couldn't even watch the video in the labor and delivery class without getting lightheaded), but it ended up being a great decision for us. There's a lot of hype around laboring/birthing methods, but we continue to believe that the most important thing is ending up with a healthy baby.

Happy One Month, Madeleine!

You may have physically only been here a month, but you've always been part of our family.

Your daddy and I love you SO much!

June 28, 2012

July 27, 2012

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